Can smoking be the reason for your persistent pain?

Chronic pain affects the well-being of millions of people worldwide. While chronic pain can have various causes, one factor that often goes unnoticed is smoking. Beyond the well-known dangers of smoking on heart and lung health, research has shed light on the correlation between smoking and chronic pain. In this blog post, we will explore how smoking contributes to chronic pain, understand the mechanisms involved, and discuss the significance of quitting smoking to alleviate pain and improve overall health.

How is chronic pain and smoking related?

Research reveals that chronic pain sufferers who smoke experience more severe pain, increased fatigue, and sleep-related impairment compared to non-smokers. The problems do not stop there. Smokers also tend to struggle with managing emotions, showing higher levels of anger, reduced emotional support, and increased feelings of depression. These psychosocial issues directly or indirectly contribute to chronic pain among smokers. This creates a vicious cycle. The worsening pain negatively impacts mental well-being, and in turn, declining mental health exacerbates a smoke’s pain.

Moreover, studies have shown that smokers have poorer pain management and greater functional limitations compared to non-smokers. As a result, it is not surprising that smoking is associated with poorer recovery and slower improvement over time. Understanding these complex relationships emphasises the significance of addressing smoking cessation as a crucial step towards enhancing pain management and fostering better overall outcomes for individuals living with chronic pain.

Smoking can cause a constant low grade inflammation in your body

smoking singapore
Smoking literally kills On top of a shorter life expectancy smoking also contributes to increased pain This means smokers often have poorer quality of life

When you smoke, you expose yourself to harmful chemicals like nicotine, acetaldehyde, and acrolein that trigger inflammation in your body. Inflammation is a natural defense mechanism and plays a crucial role in the tissue healing process. When you experience an injury or damage to your body’s tissues, inflammation is initiated to repair the affected area. The increased blood flow to the injured site brings essential nutrients and immune cells that promote healing and remove damaged cells.

In smokers, however, the natural process of inflammation is disrupted leading to a state of constant inflammation. Chronic inflammation occurs when the body’s immune system is continuously activated and has no time to return to a balanced state. Normally, inflammation is a protective response triggered by the immune system to heal injuries and fight off infections. Once the threat is resolved, inflammation would subside, and the body returns to its regular state.

However, in cases of smoking-induced chronic inflammation, the immune system remains in a constant state of alertness. This state of uncontrolled inflammation contributes to a cascade of negative effects, including tissue destruction, organ dysfunction, and an increased risk of developing chronic diseases.

Blood plasma samples from smokers had been found to contain significantly more inflammatory markers such as C-reactive protein and Interleukin-6 compared to non-smokers. Both of these markers are associated with chronic pain.

Overall, the impact of smoking on the body’s inflammatory response plays a crucial role in the development and persistence of chronic pain conditions. By quitting smoking, individuals can reduce chronic inflammation and improve their overall pain management and well-being.

Does smoking affect your nerves or spinal health?

disc herniation, smoking
Smoking increases your risk of getting a slipped disc Multiple studies have demonstrated that tobacco use can cause damage to your spinal discs If you are a smoker with back pain quitting smoking is going to improve your spinal health

Smoking on its own is a risk factor for neuropathic pain. Neuropathic pain is a type of chronic pain caused by damage or dysfunction in the nervous system, leading to abnormal pain signals being sent to the brain.

When nerves are damaged due to injury, the body’s natural healing processes will attempt to repair the damaged nerves. Cigarette smoke exposure has been shown to disrupt with this process. Smoking impairs the body’s ability to efficiently clear debris from the injured nerve site and also increases scar tissue formation. This ultimately lead to poorer outcomes for patients with nerve injury.

Even the intervertebral discs are affected with tobacco use. Smokers are more likely to suffer from disc herniation or slipped disc. In a laboratory setting, researchers were able to induce damages to intervertebral discs of rats by exposing them to cigarette smoke over eight weeks. Some of the damages reported included cracks and tears in the discs as well as misalignment of the annulus fibrosus.

If you are suffering from disc herniation or sciatica, quitting smoking can be a free solution to improve your pain experience.

Smoking can also affect your tendons

smoking, tendinopathy
Smokers are more likely to experience repetitive stress injuries such as tendinitis or tendinosis This is means tobacco use disrupts with collagen function in your body resulting in tendons that are more prone to rupture

Collagen is a crucial protein that plays a vital role in providing strength and structure to tendons. Tendons are tough bands of connective tissue that connect muscles to bones and allow us to move. Collagen forms the main building block of tendons, giving them the resilience and ability to withstand the forces generated during movements and activities.

Smoking can have detrimental effects on collagen production in the body. This can interfere with collagen synthesis and disrupt the normal processes that maintain healthy tendons. As a result, smoking has been associated with reduced collagen production in tendons.

When collagen levels in tendons decrease, the tendons become weaker and less flexible, making them more susceptible to injuries and degeneration. Weakened tendons are more prone to conditions like tendinopathy, which includes issues such as tendonitis (inflammation of the tendon) or tendinosis (degenerative changes in the tendon). These conditions can cause pain, swelling, and reduced mobility, affecting your ability to perform daily activities and participate in physical activities.

For perspective, smokers are 7.5 times more likely to experience a complete distal biceps tendon rupture. The impact tobacco use has on tendon health is significant!

Exercise helps with chronic pain

Exercise is a powerful ally in managing chronic pain due to its ability to strengthen muscles and joints. When you engage in regular physical activity, your muscles become stronger and more resilient, providing better support to your joints and reducing the strain on them. This, in turn, can alleviate pain and improve your overall physical function.

Moreover, exercise exhibits natural anti-inflammatory properties. Studies have shown that physical activity can help reduce inflammatory markers in the body, which are often associated with pain and inflammation-related conditions. For instance, exercise has been found to decrease levels of C-reactive protein (CRP), a marker of systemic inflammation, and interleukin-6 (IL-6), a cytokine involved in the inflammatory response.

By lowering these inflammatory markers, exercise can help mitigate the chronic inflammation that contributes to pain and discomfort. It creates a positive impact on your body’s inflammatory response, promoting a healthier balance and supporting the healing process.

Muscle growth is inhibited in smokers

smoking, muscle growth
Smoking impairs protein synthesis resulting in poorer <a href=httpsjournalsphysiologyorgdoifull101152ajpendo003012007 target= blank rel=noopener>muscle growth<a> This is why smokers tend to have a harder time recovering from musculoskeletal pain and injury

The problem with smoking is that it reduces the benefits that a smoker can get out of exercise. This means poorer recovery outcomes. The reason is because smoking has a detrimental impact on muscle growth. When you smoke, harmful chemicals like nicotine and carbon monoxide constrict blood vessels and decrease oxygen delivery to your muscles. As a result, the essential nutrients and oxygen required for proper muscle recovery and growth are limited, hindering the healing process.

The impaired blood flow and reduced oxygen supply in the muscles lead to slower repair and regeneration after workouts. This means that you may experience more prolonged muscle soreness and extended recovery times compared to non-smokers. The body’s ability to repair and build new muscle tissue is compromised, affecting your overall progress and performance in exercise and fitness activities.

Smoking damages blood vessels and reduces the oxygen-carrying capacity of the blood. The reduced oxygen delivery to the muscles limits your ability to perform optimally during physical activities and exercise.

As a result, smokers may experience reduced cardiovascular endurance and stamina compared to non-smokers. This means that you may not be able to train as hard or sustain intense exercise sessions for as long as non-smokers. The diminished cardiovascular fitness can lead to poorer results with exercising, making it more challenging for smokers to achieve their fitness goals and see the same improvements as non-smokers.

Risk of injury is higher for smokers than non-smokers

Because smoking literally affects how robust your muscles, tendons, and joints are, smokers are more likely to get injured. The risk of strains, sprains, and other exercise-related injuries is higher for smokers compared to non-smokers. This means extra caution is necessary to ensure safe exercising.

Precautions may include considers low-impact activities that put less stress on your bones and joints. Low-impact exercises, such as swimming, cycling, or yoga, can provide a safer alternative to heavier weight training. The downside of this approach is a slower exercise progression. While is ultimately beneficial for you, it may also prolong recovery.

Needless to say, proper form and technique are non-negotiable for smokers. Maintaining correct form during exercise ensures that you are using the right muscles and joints for each movement. This means reducing the strain on vulnerable areas. Good technique will help you optimally distribute the load properly to prevent excessive stress on specific body parts.

If you experience any pain or discomfort while exercising, it is important to stop immediately and seek medical advice. Ignoring pain can lead to further injury and worsen existing conditions. A chiropractor can to address discomfort and provide appropriate guidance for a safe exercise routine.

Do not undermine the benefits from smoking cessation

Everyone knows smoking is bad for their health and that quitting comes with a myriad of health benefits. When it comes to recurrent aches or pain, the advantages of quitting smoking are particularly evident. Research has been able to identify both physiological and psychological pathways that link smoking to pain.

The good news is that these pathways can be reversed when you quit smoking. Smoke cessation comes with tangible benefits for pain management. As the body heals from the damage caused by smoking, inflammation decreases and your muscle, nerve and joints can return to their healthy state. Not only will your health improve but you may also experience improvement in your pain.

The importance of quitting smoking cannot be overstated. By breaking free from smoking, you can alleviate chronic pain and improve overall health. If you or someone you know is struggling with chronic pain and smoking, drop us a message to learn more about how we can help. By taking the step towards a smoke-free life, you can pave the way for a healthier and pain-free future. Remember, the journey may be challenging, but the rewards in terms of improved health and well-being are well worth it.


Frustrated by the lack of results-driven and ethical chiropractic clinics in Singapore, Chiropractor Jesse Cai found Square One Active Recovery to deliver meaningful and sustainable pain solutions.

Our goal? To make our own services redundant to you.

*We do not offer temporary pain relief such as chiropractic adjustments, dry needling, or any form of soft tissue therapy.