- To assess the outcome of fibromyalgia syndrome (FMS) after cervical spine injury. Seventy-eight of 102 (77%) patients with neck injury were recruited 3 years after the original study in 1996. Twenty of the original 22 patients with FMS were available for reevaluation in 1999. A count of 18 tender points was conducted by thumb palpation, and tenderness thresholds were assessed by dolorimetry at 9 tender sites. All patients were interviewed about the presence and severity of neck and FMS-related symptoms. FMS was diagnosed by using the American College of Rheumatology 1990 criteria. Additional questions assessed measures of physical functioning and quality of life. Sixty percent of the 20 patients who had FMS in 1996 still had it 3 years later. All the 11 women with FMS, but only 1 of the 9 men with FMS, met FMS criteria in 1999. Only 1 of 58 patients who had no FMS in 1996 developed FMS. The quality of life scores for most patients improved, their tenderness scores decreased, and all remained employed. The outcome of posttraumatic FMS in patients with neck injury seems to be more favorable in men than in women; however, this finding should be interpreted with caution because of the small sample. Patients who do not develop FMS within 1 year of neck injury have a low probability of developing FMS in the future, comparable to the incidence of FMS in the general population.