Smoking and Chronic Back Pain: It's All in Your Head

Yet another reason to quit smoking:  smokers are three times more likely to suffer chronic back pain than non-smokers (subscription required), according to Northwestern University Feinberg Medical School researchers.  Interestingly, the researchers found the link between smoking and increased back pain is in the brain and not the back.  The lead author of the study noted that smoking “affects the way the brain responds to back pain and seems to make individuals less resilient to an episode of pain.”  Researchers found that two areas of the brain are critical in to developing chronic pain (nucleus accumbens and medial prefrontal cortex, NAc-mPFC).  As researchers reported, “That circuit was very strong and active in the brains of smokers … but we saw a dramatic drop in this circuit's activity in smokers who … quit smoking during the study, so when they stopped smoking, their vulnerably to chronic pain also decreased.”   

Smoking is frequently a vexing component of claims involving back problems.  We know smoking can predispose persons to back problems and significantly reduces the likelihood that back surgery will succeed.  This study demonstrates that smoking also changes the way the brain behaves, which appears to make the physical problems worse.  Claim handlers and medical professionals should exercise whatever power they have to convince persons with back problems or injuries to quit smoking immediately.  While smoking is a personal choice, worker’s compensation premiums should not underwrite the costs of that choice when, for example, a minor back strain becomes chronic, intractable, and expensive to treat because of a person's decision to smoke.    

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