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Another reason to quit smoking

It is generally known that smokers are more likely to experience low back pain (LBP) than non-smokers. However, research has not yet revealed if smoking plays a direct role in causing LBP. Two reasons why smoking might contribute to LBP include an increase in circulating pro-inflammatory cytokines and vasoconstriction, which might reduce intervertebral disc nutrient transfer.1

Recently, a clinical study took a novel approach to studying the relationship between smoking and chronic LBP.2 Petre and colleagues hypothesized that because smoking affects brain pathways that mediate pain perception, select cortical circuits may be enhanced by it, thus increasing the risk for developing chronic pain. To study their hypothesis, the authors analyzed functional magnetic resonance imaging (fMRI) scans of patients with chronic LBP and from healthy patients. fMRI scans display functional connectivity between different brain regions.

The investigators found increased brain connectivity between two areas (nucleus accumbens and medial prefrontal cortex) in smokers. Increased connectivity between these two areas of the brain has previously been determined to be causally related to chronic pain development. Study findings demonstrated that smoking is a risk factor for developing chronic LBP due to the effect it has on enhancing key brain pathways.

This information represents more bad news for smokers, but here is some good news for those thinking of quitting.

Perhaps the most interesting study finding was the change in brain connectivity for those who quit smoking during the study. Activity between the two key brain regions reduced after smoking cessation, suggesting that cortical changes may be reversible by quitting. The study is the first of its kind and it was performed with a relatively small sample size. Nevertheless, findings are intriguing and appear strong enough to provide yet another reason for non-smokers to avoid starting and for smokers to quit.

Reference List

1. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The association between smoking and low back pain: a meta-analysis. Am J Med. 2010;123:87-35.
2. Petre B, Torbey S, Griffith JW, De OG, Herrmann K, Mansour A, et al. Smoking increases risk of pain chronification through shared corticostriatal circuitry. Hum Brain Mapp. 2014.

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