Could getting the nicotine monkey off your back actually help alleviate your back pain?
New research shows a clear association between smoking and chronic pain, particularly back pain. While it wouldn’t be ethical to conduct randomized controlled trials where some participants were asked to smoke to study the effects on back pain, observational data following smokers versus nonsmokers has provided considerable support for an association between smoking and chronic pain.
The precise reasons for this are still being explored, and studies stop short of proving that smoking causes chronic back pain.
The evidence is strong enough, and studies show those who smoke who suffer from spine injuries or from other back problems that turn out to be short-term issues for some, tend to have a greater chance of going on to develop chronic pain as a result.
While smokers might feel temporary relief from pain when lighting up, the very same nicotine is working against them in other ways. “Nicotine itself is a vasoconstrictor – meaning it narrows blood vessels – so if I expose any blood vessels in my body to it, they constrict, they narrow, and less oxygen gets to it,” Barnett says. “For pain, if (I) have a bad back, I need extra blood flow to help heal … and I’m reducing that. Areas that automatically – just by the architecture of things – get little blood flow, like discs, those can degrade even more so.”
Generally speaking, more research is still needed to understand exactly why smoking might contribute to chronic pain. But where there are already countless reasons to kick the habit, this is another, clinicians say, that shouldn’t be ignored. And it’s something patients should talk to their health providers about as part of a comprehensive approach to reduce – or prevent – persistent back pain.