smoking and chronic back pain

How Chronic Back Pain is Affected by Smoking

Back pain is among the leading causes of medical issues in the US and as many as 8 out of 10 American adults will suffer from it at some point in their lives. Back pain is also one of the most common reasons for missed workdays and the second most common reason for doctor’s visits, according to the American Chiropractic Association.3

Some people who suffer from chronic back pain tend to turn to nicotine for pain relief, but studies show that smoking actually seems to worsen pain over time. In fact, smokers have been shown to be up to three times as likely to get lower back pain compared to non-smokers. Studies also show that smoking increases abdominal and joint pain, and pain sensitivity in general.4

Smoking’s Affect on Chronic Pain

According to the Centers for Disease Control and Prevention, only about 18% of people in the United States smoke, but smokers make up over 50% of patients seeking pain treatment. The problem is that the nicotine in tobacco tricks the body into feeling good temporarily by triggering the release of chemicals like dopamine, which provides a “reward” sensation. This is also what makes smoking addictive.4

Tobacco also reduces the ability of your body to deliver oxygen-rich blood to bones and tissues. In spinal discs that are already low in oxygen-rich blood, this can cause degeneration. Eventually, osteoarthritis, chronic back pain, and other conditions relating to degenerative disc disease can occur.4 

Research has also linked smoking to fatigue and delayed ability to heal injuries, both of which make pain feel worse.4

Even worse, smokers tend to be unable to receive treatments for pain. For example, some devices that need to be implanted such as neurostimulators can’t be used to treat smokers. This is because smoking impacts the immune system, increasing one’s risk of infection after surgery.4

What the Research Shows

A study led by Bogdan Petre from Northwestern University’s Feinberg School of Medicine was the first to show that smoking actually does impede the brain circuit linked to pain. This increases smokers’ likelihood of developing chronic back pain.3 

This study, published in the journal Human Brain Mapping, proposes that smokers may be able to reduce their risk of developing chronic back pain by quitting smoking. Before coming to this conclusion, Petre and his team analyzed 160 participants who had newly developed subacute back pain. In addition to these participants, they also studied 32 participants living with chronic pain, and 35 participants had no back pain.3

Over a period of one year, the team used questionnaires to gather information about participants’ smoking status and other health conditions. Participants also underwent MRI brain scans. The scans were used to evaluate activity between two brain regions, the nucleus accumbens and the medial prefrontal cortex. These two regions were assessed because they play a role in addictive behavior and motivated learning.3

The researchers found that there is a connection between these brain regions and the development of chronic pain. The greater the connection between the two regions, the more vulnerable a person becomes to developing chronic back pain, and smoking seems to affect this connection. Participants who smoked had a strong connection between the nucleus accumbens and medial prefrontal cortex and the team also found that smokers are three times as likely as non-smokers to develop chronic back pain.3

However, when smoking participants quit smoking during the study, there was a significant drop in the activity between these two regions, and their risk of developing chronic back pain dropped as well.3

Smoking affects brain connections linked to chronic pain, which shows that there is a link between smoking and chronic pain. Because of this, the researchers feel that smokers can reduce their risk of developing chronic back pain by quitting smoking.3

Another study found that people who currently smoke tend to suffer from chronic back pain more often than those who do not smoke. This suggests a biological connection between smoking cigarettes and chronic back pain in US adults. The study suggests that smoking should be considered a risk factor for developing chronic pain in general.1

Yet another study from the National Library of Medicine conducted research to determine whether or not habitual smoking is connected to physical and psychological indications of chronic pain. After reviewing patient records, the study found that 54% of patients seeking treatment for chronic back pain confirmed that they regularly smoke cigarettes.2 

Further, the research included a questionnaire about smoking which showed that 57% of patients who smoke also tend to smoke when they feel pain. While 91% of patients felt that smoking did not affect their feeling of pain, smokers showed much higher levels of emotional distress, tended to be less active, and were more likely to rely on medication than non-smoking patients. Further, the results show that patients experiencing were more likely to smoke more when experiencing a period of pain.2

What You Can Do

If you’re suffering from chronic back pain and are also a smoker, the science shows that quitting is your best bet for dealing with this pain. If you’re someone with a family history of chronic back pain and also a smoker, it is also in your best interest to quit. However, quitting smoking can be difficult and a very big step to take, so the following steps may be helpful in getting you on track to quitting.

  • Start by scheduling your quit day.
  • Ask your primary care doctor about nicotine replacement products or other medication you can take while working on quitting.
  • Call a hotline like 1-800-QUIT-NOW for free help.
  • Join a support group.
  • When you feel the urge to smoke, take a walk.
  • Start an exercise program. Exercise activates endorphins which can decrease your feeling of pain.4

You may also want to consider the Discseel® Procedure to treat your chronic back pain. If you’ve tried conservative options and failed to experience relief, it’s time for you to consider a treatment that can heal the spinal discs causing your chronic back pain. The Discseel® Procedure is a non-surgical, minimally invasive procedure that takes only 40 minutes and will allow you to be walking within 24 hours of the procedure. Apply today to find out if you’re a candidate.

  1. Green, B. N., Johnson, C. D., Snodgrass, J., Smith, M., & Dunn, A. S. (2016, September 26). Association Between Smoking and Back Pain in a Cross-Section of Adult Americans. Retrieved June 4, 2020, from 
  2. Jamison, R. N., Stetson, B. A., & Parris, W. C. (1991). The Relationship Between Cigarette Smoking and Chronic Low Back Pain. Retrieved June 4, 2020, from 
  3. Whiteman, H. (2014, November 4). Smoking linked to increased risk of chronic back pain. Retrieved June 4, 2020, from 
  4. Why Smoking Will Worsen Your Chronic Pain. (2017, August 25). Retrieved June 4, 2020, from
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