title: Effects of smoking on neuropathic pain in two people with spinal cord injury.
abstract: 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.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, Alabama 35233-7330, USA. Richards@uab.edu
authors.forename: J Scott
authors.initials: JS
authors.lastname: Richards
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Kogos
authors.forename: T J
authors.initials: TJ
authors.lastname: Ness
authors.forename: Christina V
authors.initials: CV
authors.lastname: Oleson
mesh_terms: 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
chemical_list: D011978:Receptors, Nicotinic