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Smoking May Increase Risk of Developing Neuropathic Pain


 

ORLANDO – In a community sample of 205 adults with chronic pain of any type, neuropathic pain was documented in almost two-thirds of those who smoked, compared with one-third of those who did not smoke, Dr. Todd G. Call reported at the annual meeting of the American Academy of Pain Medicine.

“The results were a little bit of a surprise to us, but it appears that smoking seems to confer a greater risk of neuropathic pain. We're not quite sure why that is. It's too early to say. The study really wasn't designed to look at that, but it's worth looking into further,” Dr. Call of the Mayo Medical School, Rochester, Minn., said in an interview.

Dr. Call and his colleagues sought to validate a method of screening for neuropathic pain in adults with chronic pain living in the community.

They identified a subset of adults with self-reported nerve pain, and confirmed the diagnosis according to scores on the self-reported Leeds Assessment of Neuropathic Symptoms and Signs pain scale and select ICD-9-CM codes associated with neuropathic pain on chart review.

Neuropathic pain was confirmed in 75 of the 205 patients. The remaining 130 patients had chronic, nociceptive pain. Overall, 13% of the participants smoked, but among patients in the neuropathic pain subset, 21% were smokers.

In another study from the Mayo Clinic, Dr. Susan Moeschler reported that female smokers attending the clinic's pain center had higher pain intensity scores than female nonsmokers and smoking and nonsmoking males.

Compared with 131 female nonsmokers, the 14 female smokers were more likely to be unemployed and less likely to have completed high school. Smokers also reported greater pain intensity, which was more likely to interfere with their mood, personal relationships, sleep, and enjoyment of life. Among the 85 men in the study, 22 of whom were smokers, smoking status was not related to any demographic, pain intensity, or mood interference differences.

“These findings suggest that female smokers with painful conditions have greater affective distress than other male smokers and other subsets of patients,” Dr. Moeschler said.

Dr. Call's study was supported by an unrestricted grant from AstraZeneca Pharmaceuticals LP and the U.S. National Institutes of Health. Dr. Call said he had no financial conflicts of interest.

Dr. Moeschler's study was supported by the Mayo Clinic's department of anesthesia institutional funds.

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