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Smoking and pain sensitivity: Is there a link?

You probably already know the health risks of smoking. Puffing away significantly increases the risk of heart disease, cancer, stroke, emphysema and chronic obstructive pulmonary disease. Though smoking rates have halved since 1991, smoking is still the leading cause of preventable diseases and death in Australia.

Smoking affects your entire body, including your musculoskeletal system. Smoking reduces your bone density, increases the risk of osteoporosis and makes your muscles more vulnerable to injury.

Smoking and pain

Smoking also makes you more sensitive to pain.

People who smoke are more likely to be living with chronic pain conditions including:

Fibromyalgia
Back pain (spine pain and lower back pain are strongly associated with smoking)
Headaches
Diabetic neuropathy.

Smoking is one of those ‘big picture’ issues that affects every aspect of your health (a bit like a poor diet or disrupted sleep).

It’s true that smoking does provide some short-term pain relief. That’s often why people find it so hard to quit.

But that relief is short-lived. With every cigarette, smoking damages your nervous system and circulatory system, eventually amplifying pain.

That can create a vicious cycle. You might smoke to relieve pain, which actually worsens it, which makes you want to smoke more.

Why does smoking amplify pain?

Smoking worsens your experience of pain because it deteriorates your body, affects the proper functioning of your organs and tissues, and slows healing.

In particular, smoking:

Narrows your blood vessels, which reduces blood flow to your muscles, bones and organs
Reduces the oxygen in your blood
Increases blood pressure
Worsens fatigue and depression
Increases blood pressure
Disrupts the brain networks involved in pain, which makes a lower level of pain feel more severe.

Smoking and musculoskeletal pain

Though we can’t yet say that smoking causes some types of back pain, we do know that smokers face a much higher risk of back pain than non-smokers.

That seems to be because smoking damages the vascular system. Without a strong supply of nutrient-rich oxygenated blood, the vertebrae (bony building blocks of the spine) and the discs between them degenerate more easily, contributing to back pain.

Simply put, smoking is bad for your joints and connective tissues. When it comes to osteoarthritis of the knee, smokers experience more severe pain and are more than twice as likely to have significant cartilage loss. That could be because toxins from smoking accelerate cartilage loss or that higher carbon monoxide levels in the bloodstream reduces the cartilage’s ability to repair itself.

Smoking and treatment outcomes

So, to recap, smoking greatly increases the risk of many conditions, including chronic pain. Unfortunately, smoking also worsens treatment outcomes, making it much harder to recover.

Smokers who have a total knee replacement are 10 times more likely to need revision surgery (do-over surgery because the first one didn’t work).

When it comes to spinal fusion, a type of back surgery, smoking reduces your bones’ ability to fuse together, defeating the purpose of the surgery. It also puts you at higher risk of infection, adjacent-segment disease, and swallowing difficulties.

Stopping smoking

It’s hard to quit an addictive habit like smoking. It’s particularly hard if you’re in pain and rely on smoking to help you cope.

That means it’s important to get help from people who understand the complex relationship between smoking and chronic pain and offer supportive, non-judgemental treatment.

Many people who live with chronic pain and smoke are also depressed. Getting the right treatment for depression may help to ease your reliance on smoking.

The good news is that quitting smoking has immediate benefits. Within just a few hours, your heart rate slows and your blood pressure stabilises. Within 24 hours, almost all the nicotine has left your bloodstream and oxygen is reaching your heart and muscles more easily. You may notice that your fingers are warmer and your hands no longer shake. By the end of your first week, you’ve got a better sense of taste and smell and higher levels of protective antioxidants in your blood.

If you’re ready to quit, then you can find some good tips here or call the Quitline on 13 QUIT (13 7848).

How can The Brisbane Spine Clinic help?

If you’re living with ongoing pain and you smoke, then you may not be the ideal candidate for surgical treatment. The Brisbane Spine Clinic provides non-invasive treatment for a range of spinal conditions, which can help to ease pain symptoms. We also work closely with others involved in your care as part of a multidisciplinary team.

If you would like to quit smoking, we can offer encouragement, advice and support, including putting you in touch with specialist services.

Please make an appointment today.