Effects of Nicotine on Spinal Cord Injury Pain: A Randomized, Double-Blind, Placebo Controlled Crossover Trial

Top Spinal Cord Inj Rehabil, 2012 · DOI: 10.1310/sci1802-101 · Published: January 1, 2012

Spinal Cord Injury Pharmacology Pain Management

Simple Explanation

This study investigates how nicotine affects different types of pain in people with spinal cord injuries (SCI), comparing smokers and nonsmokers. The research used a randomized, placebo-controlled crossover design, meaning participants received both nicotine and a placebo at different times in a random order. The results showed that nicotine reduced mixed pain in nonsmokers, but increased both mixed and neuropathic pain in smokers.

Study Duration

Not specified

Participants

42 persons with SCI (31 smokers, 11 nonsmokers)

Evidence Level

Level I: Randomized, placebo-controlled crossover trial

Key Findings

1
Nonsmokers with SCI experienced a reduction in mixed forms of pain following nicotine exposure.
2
Smokers with SCI showed an increase in both mixed and neuropathic forms of pain with nicotine exposure.
3
Mean heart rate remained elevated across time in the nicotine condition as compared to placebo

Research Summary

This study examined the effects of nicotine on different subtypes of pain following SCI, using a randomized, placebo-controlled crossover trial. The results indicated differential effects of nicotine on SCI-related pain for smokers and nonsmokers, with nonsmokers experiencing reduced mixed pain and smokers experiencing worsened neuropathic pain. The findings suggest that chronic nicotine exposure may alter nociceptive pathways, leading to enhanced pain in smokers with SCI.

Practical Implications

Targeted Interventions

The results found among smokers could lead to targeted interventions based on mechanisms underlying the nicotine-pain connection.

Smoking Cessation Programs

Further understanding regarding the effects of smoking on pain may also prompt behavioral interventions, such as individual and/or group smoking cessation programs.

Future Research

These findings, in conjunction with prior clinical observations and neurobiological evidence implicating possible mechanisms of pain in the context of nicotine use, suggest a potentially fruitful area of future research in both human and animal studies.

Study Limitations

1
Available data are descriptive/correlational and therefore cannot be used to infer causal relationships.
2
Not specified
3
Not specified

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