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Smoking and Chronic Pain

Study after study has linked smoking to chronic pain conditions–both in the onset of chronic pain and severity of that pain. These results have surprised scientists given that nicotine carries an analgesic property. Smoking cigarettes should provide pain relief. But chronic smoking weakens the body and its processes, thus allowing pain to flourish. What follows are specific ways smoking increases your risk for chronic pain and reduces your body’s ability to heal from it:

  1. Smoking causes degeneration in the musculoskeletal system. Tissue is weakened due to a lack of oxygen perfusion, causing it to become hypoxic. This leads to an increased risk of injury, impairment of bone healing, and conditions such as osteoporosis and lumbar disc diseases (Aceto MD, et. al, Br J Pharmacol 1983).
  2. Smoking leads to spinal anorexia and malnutrition. Smoking releases toxic chemicals into the body which reduces blood flow to spinal tissue. These include: cadmium, nicotine, cyanide and carbon monoxide. The reduced blood flow and perfusion to spine tissue makes the spine more prone to mechanical injury under physical stress in any form (Eriksen W, et. al, Occup Med (London) 1999; Shi Y, et. al, Anesthesiology 2010).
  3. The polycyclic aromatic hydrocarbons in tobacco smoke negate the analgesic effect of nicotine. When inhaled into the body, these hydrocarbons induce particular enzymes involved in morphine metabolism. This reduces the bio-availability of  pain relieving properties found in opioid analgesics. Thus, smokers who take opioid medications to help control chronic pain are found to take higher doses of these medicines compared to non-smokers, yet without pain relief (Pirouzi S, et. al, Addict Health 2011).
  4. Nicotine increases the concentration of calcium ions. This results in muscle contraction, which causes fatigue and pain (Goesling J, et. al, Pain 2012).
  5. Although nicotine carries analgesic properties, it also causes a reduced tolerance to pain. Once the body is deprived of nicotine’s pain relieving affects, it is left with a hyper-sensitive perception of pain. This leads to lowered tolerance levels, and the likelihood of increased dependence on pain medications.

The detrimental effects of smoking have long been known, particularly in areas of heart disease, lung cancer and vascular stenosis. For people who suffer with chronic pain, the negatives are compounded and increased. Smoking acts as a confounding factor in a multitude of chronic pain conditions. It affects a person negatively at every level: physical, mental, social and emotional.

The good news is, the negative effects of smoking begin to reverse as soon as a person quits. It’s never too late to quit smoking. And it’s certainly never too early. Stay tuned for an upcoming post from one of Blue Ridge Pain Management’s P.A.’s with specific and practical advice for kicking the habit.


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