Are Smokers More Likely to Develop Chronic Back Pain?
Smokers are 3 times more likely to develop chronic back pain than non-smokers—but kicking the habit could reduce that risk, according to a new study in the journal Human Brain Mapping.
While a number of studies have linked smoking to chronic pain, the researchers said this is the first to suggest that smoking interferes with the brain circuitry associated with pain.
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“Smoking affects the brain,” lead study author Bogdan Petre said in a press release. “We found that it affects the way the brain responds to back pain and seems to make individuals less resilient to an episode of pain.”
Petre and his colleagues at the Northwestern University Feinberg School of Medicine, in Evanston, Ill., conducted a longitudinal observational study of 160 adults with new cases of subacute back pain (lasting 4 to 12 weeks). They also looked at 32 participants with chronic back pain (lasting 5 years or more) and 35 healthy control participants with no back pain.
At five points throughout the 1-year study period, all of the participants completed questionnaires about their smoking status and other health issues, rated the intensity of their back pain, and underwent magnetic resonance imaging (MRI) brain scans.
The researchers used the scans to assess activity between two regions of the brain—the nucleus accumbens and the medial prefrontal cortex—both of which play a critical role in addictive behavior and motivated learning.
The researchers found that the stronger the connection between these two areas of the brain, the more susceptible an individual is to chronic pain.
“That circuit was very strong and active in the brains of smokers,” Petre said. “But we saw a dramatic drop in this circuit’s activity in smokers who—of their own will—quit smoking during the study, so when they stopped smoking, their vulnerably to chronic pain also decreased.”
While anti-inflammatory medications helped participants to manage their pain, they didn’t change the brain circuitry that made them more likely to develop chronic back pain. In the future, the researchers hope to see behavioral interventions like smoking cessation programs used to help prevent and/or relieve chronic back pain.
—Colleen Mullarkey
Reference
Petre B, Torbey S, Griffith JW, De Oliveira G, Herrmann K, Mansour A, et al. Smoking increases risk of pain chronification through shared corticostriatal circuitry. Hum Brain Mapp. 2014 Oct 12. [Epub ahead of print].