UPFRONT | Roundup CLINICaL Smoking linked to chronic back pain: study A new study from Chicago’s Northwestern University showed cigarette smoking can be bad for the back. “We found that (smoking) affects the way the brain re-sponds to back pain and seems to make individuals less resilient to an episode of pain,” said the study’s lead author, Bogdan Petre, in an article posted on Northwest-ern University’s website. The study was published online in the journal Human Brain Mapping. According to Northwestern University, this study is the first evidence linking smoking and chronic pain with the part of the brain associated with addic-tion and reward. The study involved a lon-gitudinal obser vational study of 160 adults with new cases of back pain. At five different times throughout the course of a year they were given MRI brain scans and were asked to rate the intensity of their back pain and fill out a questionnaire asking about smoking status and other health issues. Thirty-five healthy control participants and 32 partici-pants with chronic back pain were similarly monitored. MRI activity between two brain areas (nucleus accum-bens and medial prefrontal cortex, NAc-mPFC) was analyzed. These brain areas are involved in addictive behaviour and motivated learning. This is critical in development of chronic pain, the scientists found. These two regions of the brain “talk” to one another and scientists discovered that the strength of that connection helps determine who will become a chronic pain patient, the Northwest-ern University article stated. By showing how a part of the brain involved in motivated learning allows tobacco ad-diction to interface with pain chronification, the findings hint at a potentially more general link between addic-tion and 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 vulnerabality to chronic pain also decreased.” Medication, like anti-in-flammatory drugs, did help participants manage pain, but didn’t change the activ-ity of the brain circuitry. In the future, behavioural inter-ventions, such as smoking cessation programs, could be used to manipulate brain mechanisms as an effective strategy for chronic pain prevention and relief, the report said. Canadian Memorial Chiropractic College 14 Canadian Chiropractor December 2014 www.canadianchiropractor.ca
Chiropractic + Naturopathic Doctor December 2014: Page 14
