To ease severe back pain, quit smoking

U. ROCHESTER (US) — Quitting smoking offers significant relief to people suffering from severe back pain, new research suggests.

Published in the Journal of Bone and Joint Surgery, the study analyzed more than 5,300 patients followed for eight months during treatment of spinal disorders and showed that cigarette smokers reported far more pain than never-smokers or those who had quit.

Smoking cessation either prior to treatment or during the course of care was related to significant improvements in pain—a result that underlines the need for structured stop-smoking programs among the legions of patients who experience back pain due to degenerative disease, deformity, or musculoskeletal problems.

“We found that people who stopped smoking had meaningful benefit by reduction of their pain,” says Caleb Behrend, chief resident in the Department of Orthopaedics and Rehabilitation at the University of Rochester Medical Center. “The pain improvement is in addition to all the other benefits you gain from quitting.”

The relationship between pain and smoking is complex and full of contradictions. Nicotine has analgesic properties, for example, and yet clinical evidence shows that smokers are at higher risk for developing back pain and other chronic pain disorders, according to the American Society of Anesthesiologists.

Scientists already know that nicotine interacts with a family of proteins (nAChR), which have a key role in the central, and peripheral nervous system, and control anxiety and pain. Prolonged exposure to cigarettes upsets the function of these cells and eventually changes the way pain is processed, as well as impairing oxygen delivery to tissues, predisposing a person to bone and joint disorders such as osteoporosis, and inducing inflammation and depression. Smokers with spinal conditions also tend to have persistently more intense pain and more long-term disability.

The new study notes a daunting fact: Nearly all people will experience back pain at some point in their lives and many will seek medical care. Because the socioeconomic impact of spinal disorders (cost of care and lost productivity for patients) is so great, researchers want to find out if improvements in pain could be achieved with a cost-effective intervention such as smoking cessation.

Researchers reviewed a prospectively maintained database of 5,333 patients, who completed questionnaires about pain at the initial doctors’ visit and at the time of discharge from care. Patients were treated with surgery, or with physical therapy, injections, over-the-counter medications, and home exercise programs. Physicians counseled all smokers to quit, and patients were referred to a smoking cessation hotline.

Of the 5,333 people, those who had never smoked or had quit some time ago reported less pain than smokers or those who had just quit. By the end of the follow-up period, the people who had recently quit or who quit during treatment showed significant improvements in pain. People who continued to smoke during treatment had no improvement in pain on all scales.

Younger people tended to comprise the group of current smokers and those who only decided to quit during treatment; this is consistent with other studies showing that smoking is associated with degenerative spine disease at a younger age.

Older patients tended to comprise the group who had never smoked or quit long ago.

The rate of smoking cessation was 22 percent, and research shows that up to 36 percent of patients with painful spinal disorders are able to quit with help from a structured program. A grant from the Southwestern Medical Foundation was used to create and maintain the patient database.

Source: University of Rochester

chat11 Comments


  1. Back Pain Philippines

    I was a smoker when I was a teenager but I quit four years ago and so far, the only time that I experience lower back pain is when I don’t sleep properly. Other than that, I also get back pain from too much stress and work but I only have it in the upper left part of my back. I guess, the bottom line here is that smoking does not really help you at all. It just adds injury to your body so as early as today, they should stop it.

  2. stacie

    I just quitted smoking but unfortunately my back pain still persists. However, I’ve recently found out that a Toronto fascial stretch therapy program can ease severe back pain. I should follow this program and see if anything happens. I’m an optimistic person and I hope everything will work great for me!

  3. Metzler Chiropractic

    is it ture, does smoking have anything related to back pain…

  4. back pain lower

    Several research studies support the use of chiropractic care for the treatment of low back pain. Several leading authorities and published guidelines recommend chiropractic care to be included in the early stages of care for low back pain. In addition to spinal manipulation, many chiropractors also offer other beneficial healthcare services. Physical therapy modalities are often utilized by chiropractors to help heal injured soft tissue which is common with spinal problems and to reduce inflammation. Some of these might include electric stimulation, ultrasound, traction and cold laser therapy.

  5. back pain lower

    Chiropractic treatment often involves exercise instruction from the doctor. Prognosis is often greatly improved by including exercises. Exercises might include cardiovascular, strengthening and stretches to help stretch muscles, improve range of motion and improve posture. Exercises can be effective to strengthen muscles that are weak along the spine or pelvis. Core strengthening exercises are important to help stabilize the spine and prevent future problems. Chiropractors also prescribe arch supports which help to stabilize the pelvis and spine.

  6. julianswilson

    Studies have been made that people who smoke have a very much risk of getting more pain. Also it has been found that chain smokers have a risk of developing lumbar spondylosis.

  7. peter - stop smoking (South Africa)

    I guess it comes down to the fact that smoking causes so much damage and interferes with so many bodily processes that just about any adverse effect can be traced back to it.

    (similar to stress wreaking havoc on the body)

    Ironically, I just read about smoking contributing to anxiety…

    Now – from what little I head to learn the hard way about back pain, stress causes the body to withdraw fluid from the lower back…

    So – smoking = more anxiety = back pain

    Just one more way in which smokers are hurting themselves

  8. Devin

    I quit smoking because my surgeon said he refuses to operate on a smoker. Have scoliosis, and a fusion almost 3yrs ago from T11 to L2- top level of said fusion never took allegedly due to my smoking habit. Whoever claims non smokers and/or quitting will relieve pain is an effin liar. I’m in 5x more pain now than I ever was as a smoker. I’m not starting up again because I so desperately need this revision surgery, I’m just saying I don’t believe this “study” to be accurate for everyone based on my experiences. I’m also not saying smoking is good for a person, but geeze. My muscle spasms have increased so dramatically I’ve had to triple my pain medication and muscle relaxer medications… the nerve damage pain I have in my leg is so severe I wake up crying every morning… my anxiety is ten times worse than it ever was as a smoker- and I was diagnosed with GAD awhile back… The initial withdrawal stuff sucks, as to be expected, but ***does the pain ever get any better?*** Cuz if it doesn’t I’m starting up again after my surgery/recovery is completed. I’m not exactly the most “fit” person around, but I do stretch regularly and do a series of physical therapy exorcises daily… none of this helps. My mom recently quit smoking too, she’s like 6 months from her quit date and has had more pain since quitting than any time in her entire life. So… wtf?

  9. Samantha F. Hughes

    You must know why you want to stop smoking. Having shallow reasons, like it is bad for you are not good enough. To really get yourself motivated, you need a personal and powerful reason to quit. Maybe you are scared of lung cancer. Or maybe you would like to keep your family from second hand smoke. It might be because you want to both feel and look younger. Choose a strong reason that outweighs your urge to light up.

  10. Msty Owens

    I’m very happy that I’ve stumbled on this site

  11. elnino

    I started having this back pains a few months ago..I noticed that whenever i stretched in some type of way i feel pops from in my back..i thought it was probably my bed.Now its kinda getting worst because it wont stop hurting..
    Im starting to think its something that has to do with my smoking habit..

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