Practice and Procedure


PUBLISHED March 11, 2003

The judge was correct in deciding on the evidence of the expert witnesses that the claimant suffered from fibromyalgia and that the condition had been caused by a road accident.Appeal from a decision of Mr Recorder Prosser on 13 September 2002 whereby he decided that the claimant (JB) suffered from fibromyalgia and that that condition had been caused by a road accident on 29 April 1997. The claimant was born on 10 July 1960 and was aged 36 when the accident occurred. Before the accident, she had from her teenage years suffered intermittent lower back pain. She was diagnosed four years before the accident as suffering from endometriosis. She also suffered from dyspareunia, and experienced difficulty becoming pregnant. In October 1996 she had experienced a crushing chest pain that lasted 3 or 4 days. The claimant visited her GP in September 1997, who recorded the road traffic accident. The judge's explanation of fibromyalgia came from a Textbook of Rheumatology (5th Ed 1997) where it was said to be a syndrome of widespread musculo-skeletal pain and fatigue arising in particular from poor sleep. The judge said that the condition was diagnosed by reference to the patients history and by an examination by a doctor of 18 trigger points on the quadrants of the patient's body. To meet the diagnostic criteria pain had to be present at 11 or more of the 18 specified tender point sites upon digital palpation. The description derived from the American College of Rheumatology (ACR). The defendant appealed submitting (i) the judge having accepted the definition of Fibromyalgia adopted by the ACR failed properly to apply it to an analysis of the claimant's complaints. (ii) in cases of fibromyalgia resulting from trauma, the patient would experience within four to six months of the trauma increasing symptoms of the condition, including pain in all four quadrants of the body (iii) the variation in the number of tender points found by different doctors on different examinations was inconsistent with a diagnosis of fibromyalgia.HELD :(1) The analysis given by the chief expert witness was consistent with the claimant's medical reports and the description of fibromyalgia adopted by the ACR. (2) The view of the defendant that the analysis was to be rejected because the records did not reflect new complaints immediately recognisable as symptoms of fibromyalgia assumed a rigid view of the nature of the condition which was not shared by any of the medical experts who gave evidence. (3) The judge had been entitled to accept the evidence of the main expert witness that the condition had been caused by the accident.Appeal dismissed.