Canadian researchers say patients with spinal cord injuries have a higher risk of heart disease and stroke, similar to that of smokers, diabetics and the obese.
The risk of cardiovascular disease was nearly 3 times higher for spinal cord patients, according to a study published in the journal Neurology. The risk of stroke was almost 4 times higher.
“To put these values into context, the heightened odds ratios reported here are similar in magnitude to the estimated odds ratios in the general population for the relationship between smoking and myocardial infarction (heart attack),” wrote lead author Jacquelyn Cragg of the University of British Columbia.
Cragg and her colleagues studied health data from over 60,000 people who participated in the 2010 Canadian Community Health Survey.
From that sample, they identified 354 people who reported having both a spinal cord injury and a stroke, and 356 people who had a spinal cord injury and cardiovascular disease.
While the research did not establish a cause for the higher risk profile, the authors noted that spine injuries can increase several risk factors for cardiovascular disease, such as physical inactivity, high blood pressure, and chronic inflammation.
“I do know that inactivity and pain cause heart problems, as I am having problems with that at the moment,” said Walt Davis, who has suffered from back pain for 30 years and is a patient advocate for the Arachnoiditis Society for Awareness and Prevention (ASAP).
Davis says the study’s findings are no surprise to him.
“High levels of pain have been proven without question to elevate the heart rate to near stroke levels. Neuropathic pain that is hard to control is the main culprit. There is much debate over metabolic disease, but a chronic pain patient is more likely to have this disease due to being overweight from medications and a decrease in activity,” Davis said.
Patients with back pain are usually treated with anti-inflammatory drugs, painkillers or physical therapy. But if symptoms persist, an epidural steroid injection or surgery is often prescribed to alleviate pain, which can lead to further complications. One of the most severe is arachnoiditis, an inflammation in the membrane that surrounds the spinal cord.
“If a spinal cord injury leads to arachnoiditis or another intractable pain condition, the effects on the body if the pain is improperly treated can shorten the lifespan up to 12 years or more,” says Dawn Gonzalez, whose spine was damaged by an epidural during child birth.
Like Davis, Gonzalez now suffers from arachnoiditis and is an advocate for ASAP.
“With the situation we have today where doctors are less willing to treat this type of pain properly with opioid therapy due to rules and regulations from the DEA, we are going to see a huge rise in not only cardiovascular issues in these patients, but suicides,” Gonzales said in an email to National Pain Report.
“Arachnoiditis leaves the patient’s body in constant stress and turmoil. Several of our patients have been hospitalized with undertreated pain due to the stress response in their body that leaves them in cardiac distress, with stroke-level blood pressure levels and heart rates. What many doctors don’t realize is that undertreated intractable or chronic pain can be very, very deadly.”
But pain relieving drugs carry risks of their own. Several recent studies have linked serious health problems to non-steroidal anti-inflammatory drugs (NSAIDs) and other over-the-counter painkillers.
A Dutch study found that one out of eight patients who use NSAIDs were at high risk of internal bleeding, peptic ulcer, high blood pressure or heart failure.
Another study, a review of nearly 650 clinical trials involving more than 353,000 patients, found that high doses of NSAIDs doubled the risk for heart failure.
European and Canadian health officials have also warned people with heart or circulatory problems not to use the pain reliever diclofenac. Although not widely sold in the U.S., diclofenac is the most popular NSAID in the world, outselling ibuprofen and naproxen.