Thresholds for fibromyalgia and concussion diagnosis lowered

Thresholds for the diagnosis of fibromyalgia and concussions have been lowered, creating more exposure for claims under the accident benefits scheme.
Dr. Arthur Ameis expressed this view during a panel discussion at the Canadian Defence Lawyer’s Accident Benefits seminar held in Toronto on Oct. 21.
The American College of Rheumatology suspended the use of the ‘tender point test,’ a physical exam to diagnosis fibromyalgia, in 2010 because it felt too many patients were being left out of the diagnosis. Instead, the physical exam was replaced with a 24-question survey about the patients’ symptoms.
“So, we are going to see a new wave of fibromyalgia diagnosis because the tender point test is out and you’re not even supposed to touch the patient,” Ameis said. “The difficulty is that people can go online and read the answers and the diagnosis will happen more and more.”
Ameis described a second trend involving the diagnosis of concussions, known as the Sydney Crosby Syndrome. “Well-intentioned physicians are now saying that we are under-diagnosing concussion,” he said. “A well-respected physician said during a recent talk that 95% of concussions do not involve the loss of consciousness.”
The threshold has been opened up so that if a patient experiences dizziness, nausea, double vision or memory problems following an accident, he or she is considered to have a concussion.
“The treatment for concussion is rest,” Ameis said. “Rest from work, rest from school, rest from housework. And when does rest end? When the symptoms end. When your headache stops, you can go back to work.
“If you go back to work and your headache comes back, stop working until it goes away, no matter how long it takes.
“We have a situation where we have lowered the threshold for fibromyalgia and we have lowered the threshold for concussion. We are in for some interesting legal times.”