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Fibromyalgia Patients Beware: Tobacco Use Increases Pain Intensity
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Posted on: 11/30/1999
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Smoking (tobacco use) has been shown to increase pain intensity among patients with chronic pain. Fibromyalgia is one of those conditions with chronic musculoskeletal pain. So, does this association between smoking and pain apply to patients with fibromyalgia? That's what the authors of this study set out to investigate.
They evaluated patients from the Mayo Clinic Fibromyalgia Treatment program. Those who smoked were placed in one group. Those who did not smoke were in a second group. About 15 per cent of the total group smoked.
Everyone was evaluated first by a registered nurse. Information was collected about their social background. Questions were asked about age, gender, marital status, educational level, and tobacco use.
Then, a physiatrist (rehab specialist) or rheumatologist (arthritis specialist) saw the patients to confirm a diagnosis of fibromyalgia.
Everyone filled out the Fibromyalgia Impact Questionnaire (FIQ). The FIQ measures pain severity and function. The higher the score, the greater the impact of fibromyalgia on the patient's work and home life. Scores range from zero (no problem) to 100 (severe loss of function; disabled).
The scores on the FIQ were compared between the smokers and nonsmokers. They found one major difference: tobacco users did have much higher pain levels compared with nonsmokers. Other differences included: the tobacco users had higher FIQ scores, indicting a greater effect of the fibromyalgia on their daily function. Smokers were more likely to live alone and to be unemployed. There was also a higher incidence of abuse (history of sexual, physical, or verbal abuse) among the smokers.
They did not find a greater number of tender points in smokers with fibromyalgia compared with nonsmokers. The study could not answer the question of whether tobacco use puts people at greater risk of developing fibromyalgia than people who don't smoke.
The mechanism by which tobacco increases pain intensity is being studied. Scientists think that tobacco increases substance P in the cerebral spinal fluid. Substance P helps transmit pain signals. At the same time, smokers have lower endorphin levels (natural pain killers). In addition to these two factors, there may be a connection between depression and smoking and between fibromyalgia and personality disorders. When all put together, the impact of these variables on fibromyalgia and pain intensity could be significant.
The results of this study were consistent with other studies linking smoking with pain (e.g., low back pain), more severe symptoms from other musculoskeletal disorders, and loss of function. The smokers with fibromyalgia were also more likely to miss days of work.
There are still many unknowns in the field of fibromyalgia. Do smokers (or tobacco users) respond to treatment for fibromyalgia differently than nonsmokers (faster? with different treatment?)? Do smokers with fibromyalgia have a harder time quitting smoking (or quitting using tobacco)?
Future studies may take a look at some of these questions. For now, the authors conclude that tobacco use is linked with worse symptoms in patients with fibromyalgia. It is always advised that patients should quit smoking. Patients with fibromyalgia should be encouraged to enter a tobacco-cessation program not only to reduce pain but also for their overall better health.
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References:
Toby N. Weingarten, MD, et al. Impact of Tobacco Use in Patients Presenting to a Multidisciplinary Outpatient Treatment Program for Fibromyalgia. In The Clinical Journal of Pain. January 2009. Vol. 25. No. 1. Pp. 39-43.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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