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Smoking and back pain

Issue 38 Synovium (Spring 2013)

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Following on from the report in Synovium 37 that in patients with chronic widespread pain (fibromyalgia) smoking is associated with increased pain, more depression and more anxiety comes evidence that in patients with spinal disorders smoking is also associated with increased experience of back pain and that ‘quitting’ is associated with reduced experience of pain. In a study published in the Journal of Bone and Joint Surgery1 data was collected by questionnaire from 5333 patients at ‘entry into care’ and compared with data collected at ‘latest follow-up’. Current smokers were found to have higher levels of pain, measured by visual anologue scale (VAS), compared with never smokers (mean VAS 4.49 vs 3.59). Quitting smokers reported reductions in worst pain, current pain and average pain of 1.57, 1.07 and 1.23 respectively on VAS. This increases the weight of evidence suggesting all patients with chronic pain who smoke should be advised of the benefits of quitting and that smoking cessation should be an integral part of chronic pain management programmes. 

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