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Like storm fronts colliding 

 •  • by Paul Ingraham
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Weekly nuggets of pain science news and insight, usually 100-300 words, with the occasional longer post. The blog is the “director’s commentary” on the core content of a library of major articles and books about common painful problems and popular treatments. See the blog archives or updates for the whole site.

When I first studied biology, I was amazed to learn how almost every system and organ was adversely affected by smoking. That smoke gets into everything! People rarely connect smoking with chronic pain, because pain is so multifactorial that the role of smoking is lost in the mess of possibilities — two complex phenomena interacting, like storm fronts colliding. But that’s exactly why it’s relevant: practically everything affects chronic pain, and smoking affects practically everything, so there’s bound to be overlap. And there is. For instance, a new paper (Petre et al) that “smoking increases risk of transitioning to chronic back pain, an effect mediated by corticostriatal circuitry involved in addictive behavior and motivated learning.” See my new, short article Smoking and Chronic Pain.

I’m thinking about smoking today because of Harriet Hall’s post on, “Smoking Cessation and the Affordable Care Act.” Nowhere in medicine is it more obvious that the idea that “doctors don’t care about prevention” is absurd anti-medical propaganda. (Mine is so diligent about diet, exercise, sleep, stress, etc that he’s downright annoying about it. In a good way, of course!)

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