Chronic pain affects over 50 million people in the United States alone. According to the Centers for Disease Control and Prevention (CDC), 34.1 million Americans smoke, with more than 16 million seeking treatment for tobacco-related diseases. While fewer people are smoking now than in the past, individuals with ongoing physical discomfort are more likely to take up smoking. Many people believe that nicotine relieves both mental and physical stress, but its effects are short-lived. In turn, smokers are also at an increased risk of developing chronic disorders due to the chemicals in cigarettes. For people struggling with smoking or discomfort, learn more about how both can affect your well-being and how to improve your health drastically. 

Why Do People Associate Smoking With Relief? 

Many smokers use tobacco products for the emotional or physical comfort they provide. On an emotional level, nicotine and a person's mood are related. At first blush, nicotine stimulates a neurotransmitter called dopamine, which is a chemical messenger responsible for “feel good” emotions. Once triggered, smokers experience a noticeable decrease in anxiety, stress, and depression. The dopamine release is due to the concentration of nicotine found in cigarettes and many other tobacco products. Nicotine stimulates a dopamine response, signaling the brain to associate positive feelings with these products. 

However, the positive feelings don't last. The relief that smokers feel is actually a relief from nicotine withdrawal. They're difficult to differentiate since they share feelings of anxiety, stress, and depression. 

How Does Smoking Impact Chronic Pain? 

Worsening of Symptoms

Nicotine affects chronic pain similarly to the way it does emotional distress. It provides a release of reward neurotransmitters, like serotonin and dopamine. The pain briefly subsides, but smoking worsens their symptoms over time. 

Tobacco damages the nervous system, which increases pain sensation and pain perception. A non-smoker with a broken wrist is likely to report less discomfort than a smoker with the same injury. 

The magnified pain can also be attributed to smoking's effect on blood flow. Once consumed, tobacco slows the delivery of oxygen-rich blood to the body's tissue and organs. The decrease in nutrients and blood flow causes degeneration in the affected areas. 

People with back pain are prone to the worsening of symptoms if they continue smoking. The discs of the spine have limited blood flow, which will further decrease with tobacco use. In turn, many smokers experience increased lower back pain. Smoking causes severe disc degeneration and a weakening of spinal ligaments over time.

Decreasing Treatment Options

Many people with chronic conditions take prescription painkillers to ease their symptoms. However, due to reduced blood flow, smokers require larger or more frequent doses to manage their pain. 

Smokers also have fewer advanced treatment options. Surgeons often implant neurostimulators in patients with ongoing discomfort. They're devices that send minor electric currents to the epidural space near the spine. Neurostimulators don't relieve pain, but they disrupt the pain signals before they reach the brain. The discomfort still exists, but the brain doesn't register it. 

Smokers aren't likely candidates for implantable devices or other invasive and non-invasive procedures. Smoking compromises the immune system, which increases the risk of infection after surgery. 

Does Smoking Cause Chronic Pain?

The more an individual smokes, the more likely they are to develop chronic conditions. A 2018 study found that cigarettes lead to decreased bone mass and a bone turnover imbalance. Smokers with bone mass changes are vulnerable to chronic pain conditions, like osteoporosis.

Once formed, osteoporosis causes fatigue, weakness, and increased joint discomfort. Reduced bone mass will also leave smokers vulnerable to fractures with increased severity.

When a bone breaks, the body's stem cells replace what's lost or damaged. They form cartilage cells to close the fracture. Bone-building cells called osteoblasts then produce minerals to change and fill in the break. Within three months, the fracture usually heals. However, nicotine slows the healing process by limiting blood flow, increasing recovery time. Smokers will experience extended bouts of discomfort, and the bones are less likely to heal fully. When a bone breaks, patients are more likely to sustain widespread and chronic pain conditions later in life. If the patient is also a smoker, the discomfort will be more intense and more difficult to treat.

The short-term relief isn't worth the long-term consequences of nicotine use. For over 20 years, the physicians at Urgent & Primary Care have helped individuals throughout Albany, NY, quit smoking. They also offer chronic pain management treatments to improve their patients' overall health and quality of life. To provide the same level of dedicated care, their doctors are seeing patients virtually through Teladoc® during COVID-19. For more information on their practice or to schedule an appointment, call them at (518) 463-8262.