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In recent decades, smoking has become the medical profession’s grand bogeyman-in-chief. As a smoker (which I’m not), you must run the gauntlet of eye-watering cost, prophetical messages of doom, explicit medical imagery, and social ostracisation. All that before you can take a single and undoubtedly deeply satisfying drag! Twenty years ago, smoking was a known risk factor for a number of heart and lung conditions and a handful of cancers. Since then, that list has grown exponentially. But what about CRPS and smoking?
Is smoking a risk factor for developing CRPS?
Many years ago, in one of my first CRPS cases, a medical report mentioned smoking as a risk factor for CRPS. The medical expert based this statement on a dated, small-scale study of 53 patients, with data collected between 1978 and 1985. The study’s authors concluded that “smoking is statistically linked to” CRPS, with 68% of those in the study diagnosed with CRPS being smokers.
Forty years ago, a substantially higher proportion of the population smoked than now. So, in addition to the modest sample size, coincidence likely skewed the data. Indeed, subsequent studies have failed to reproduce these results. However, that does not seem to discourage some medical experts from continuing to cite this study as evidence that smokers are the authors of their own misfortune when it comes to CRPS. Interestingly, I have only ever seen this argument raised by experts instructed by defendants!
Can smoking exacerbate CRPS or cause it to spread?
Whether or not smoking is a risk factor for developing CRPS, do smokers with CRPS fare more badly in terms of their symptoms becoming worse or spreading?
I’m only aware of one study on this issue, and no relationship was established between smoking and levels of pain in CRPS. However, the researchers did identify a statistically higher pain-related anxiety score among those with CRPS Type 1 who both smoked and consumed caffeine.
With a dearth of available evidence, I contacted a clinical CRPS researcher, who spoke on condition of anonymity. They told me:
“We actually have no data at all to suggest that stopping smoking actually helps the condition. Stopping smoking does improve wound healing, which is independently impaired by CRPS. Therefore, it’s not a good idea to smoke if you suffer from CRPS and are recovering from surgery. However, whilst smoking carries a host of significant health risks of which we are all aware, I cannot say that there is any evidence that smokers with CRPS fare any more badly than non-smokers in terms of the symptoms of CRPS or its spread.”
It goes without saying that we should all encourage smokers to desist in the interest of their overall health. That said, I have seen no persuasive evidence that smoking is either a risk factor per se for CRPS or that smokers with the condition fare more badly than non-smokers.
Final words
I should leave the final words to a client with CRPS, who is also a smoker:
“I only smoke about three a day now on average, sometime one or two more particularly if I’m having a pain flare. That’s a hell of a lot less than I smoked before I had CRPS. I’ve tried to kick it altogether but when I do, on top of everything else, it just makes my stress go through the roof. It really is my little stress reliever. Even my doctor says he can understand that and has stopped nagging me to quit, although I doubt he’d say it officially! It just helps me to cope. To be honest, I really don’t care these days about all the risks of smoking. When you suffer with CRPS, life can’t get much worse anyway!”