Read This If You Are a Smoker Who Struggles With Chronic Pain

How nicotine makes you feel good at first, and then worse

Cigarette Butt

Next time you crave relief from back pain, abdominal pain or other chronic discomfort, don’t light up that cigarette.

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Smokers are nearly three times as likely to get lower back pain, says Bruce Vrooman, MD, a specialist in Cleveland Clinic’s Department of Pain Management. Smoking also may aggravate abdominal pain and joint pain and increase pain sensitivity in general.

“While some patients appreciate the short-term, nicotine-induced relief of a cigarette, it may actually worsen their pain over time,” says Dr. Vrooman.

About 18 percent of people in the U.S. are smokers, according to the Centers for Disease Control and Prevention. Yet smokers make up more than 50 percent of patients who seek pain treatment.

How smoking hurts

Nicotine in tobacco can trick a body into feeling good — at first. It triggers your body to release chemicals like dopamine, which gives off a satisfying, “reward” sensation. That’s what makes smoking so addictive.

But that same tobacco also impairs the delivery of oxygen-rich blood to bones and tissues. Decreasing blood and nutrient flow can cause degeneration, particularly in discs in the spine, which already have more limited blood flow. The result can be lower back pain and sometimes osteoporosis.

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Physicians also link smoking with fatigue and slower healing, factors that make painful conditions more prominent. Researchers are exploring even more physiological reasons why smoking makes people with fibromyalgia, arthritis and other chronic pain hurt more.

First step to managing pain: Quit smoking

“Almost everyone knows smoking can cause cancer, lung disease and cardiovascular disease. That’s nothing new to smokers,” says Dr. Vrooman. “But sometimes they listen more closely when you tell them that smoking makes their pain worse.”

It really hits home, he says, when someone with debilitating pain needs to reconsider a potentially life-changing treatment because they smoke.

Smokers aren’t the best candidates for implantable devices, like neurostimulators that block pain sensation,” says Dr. Vrooman. “Smoking impairs a patient’s immune system, increasing their risk of infection after surgery.”

That’s why Dr. Vrooman actively counsels patients to quit smoking.

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“I explain how it may be the greatest way to improve your health and manage your pain,” he says.

Dr. Vrooman advises patients to:

  1. Schedule a quit day.
  2. Call 1-800-QUIT-NOW for help from trained coaches.
  3. Build a support team of family and friends.
  4. Join a support group.
  5. Talk to a primary care physician about using medication or nicotine replacement products.
  6. Consider additional treatments like acupuncture or hypnosis.

Take a walk instead

“When smokers claim cigarettes help them cope with pain, anxiety or stress, I tell them there are healthier ways to do that,” says Dr. Vrooman.

Take a walk, he suggests. Or start a new exercise program. Exercise activates endorphins, molecules in your brain that provide the same pain-blocking, sometimes euphoric effect as morphine.