Effects of smoking on neuropathic pain in two people with spinal cord injury.
OBJECTIVE
To describe an apparent relationship between smoking and the neuropathic pain experience in people with spinal cord injury (SCI).


METHODS
Case Reports.


METHODS
Two individuals treated at a rehabilitation center. The first was a 38-year-old white man with a T1 2 SCI, American Spinal Injury Association (ASIA) impairment scale (AIS) A, secondary to motor vehicle crash. Duration of injury was 14 years. He reported burning pain in his legs, and has smoked 1/2 pack per day for the last 15 years. The second was a 55-year-old African American man with a T6 SCI, AIS A, secondary to gunshot wound. Duration of injury was 22 years. He was a 40-year 1/2 to 1 pack per day smoker, who, after injury, consistently experienced burning, radicular pain, rated 7/10, around the level of the injury.


CONCLUSIONS
The first subject rated his pain as 4/10 when not smoking and 7/10 when smoking. The pain subsided 30 minutes after smoking was discontinued. He noted an immediate increase in neuropathic pain when smoking. The second subject quit smoking for 1 month and immediately noted that the pain disappeared, rating it 0/10. After he resumed smoking, his radicular pain was 8.5/10 in the morning and 5/10 in afternoon.


CONCLUSIONS
No similar reports have been published, based on a MEDLINE search. Nicotinic receptors have been implicated in pain perception. It is unclear to what extent these 2 cases generalize to the SCI population. We plan to explore this via survey and experimental research. Smoking cessation may have a dual benefit of increased health and decreased neuropathic pain.
Richards
J Scott
JS
Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama 35233-7330, USA. Richards@uab.edu
Kogos
Stephen C
SC
Ness
T J
TJ
Oleson
Christina V
CV
D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D009619:Nociceptors / Q000503:physiopathology; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D010147:Pain Measurement; D011978:Receptors, Nicotinic / Q000502:physiology; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000503:physiopathology*; D016540:Smoking Cessation; D020886:Somatosensory Disorders / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D013997:Time Factors
D011978:Receptors, Nicotinic