In this week's episode of the Spine & Nerve podcast, Dr. Brian Joves and Dr. Nicolas Karvelas discuss the impact that smoking tobacco can have on the chronic pain disease processes.

Smoking tobacco can contribute to the development / worsening / persistence of chronic pain processes, and additionally tobacco use can also decrease the probability that a treatment will work for patients.  

 

It is well researched and documented that smoking has a negative impact on our health including but not limited to cardiovascular disease, lung disease, cancer risk; but there is also growing evidence that smoking tobacco can contribute to and worsen common chronic pain disease processes including chronic low back pain.  Just as we have blood vessels supplying our heart and lungs which smoking can compromise, there are blood vessels supplying our spine and smoking tobacco can have a negative impact on this blood supply and ultimately the spine.

 

Smoking tobacco has been shown through research to contribute to inappropriate inflammation, immune system abnormalities, autonomic nervous system dysfunction, ischemic states (compromised blood supply to important systems throughout the body).  This has a significant negative effect on chronic pain processes and the treatments we have available to us.

Complex Regional Pain Syndrome (CRPS) was discussed in a prior episode (https://anchor.fm/spine/episodes/What-exactly-is-complex-regional-pain-syndrome--Part-1-e52ql0 ) and is one of the correlates used for chronic pain. It has been shown that smoking tobacco and CRPS cause similar pathologic processes in the body, and this may help explain why patients with CRPS who smoke tobacco do not respond as well to one of our most powerful treatment options available for CRPS, spinal cord stimulation.  

Listen in as the doctors explore the recent research, and apply the results to the overall approach to a chronic pain patient who also utilizes smoking tobacco.

 

References:

1. Mekhail N, Costandi S, et al.The Impact of Tobacco Smoking on Spinal Cord Stimulation Effectiveness in Complex Regional Pain Syndrome Patients. Neuromodulation. 2020; 23: 133-139.

 

This podcast is for information and educational purposes only, it is not meant to be medical advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, they may not represent the views of Spine & Nerve.