There are important links between tobacco use and chronic pain. The nicotine acetylcholine receptors play a pivotal role in pain management. When individuals experience chronic pain and smoke, these behavioral cues intertwine.
Additionally, environmental factors, including the level of support, family/social issues, and impaired functionality due to pain, contribute to this connection.
Initially, acute excessive nicotine use is known to have short-term analgesic effects, but ongoing chronic nicotine exposure leads to the tolerance of this analgesic effect.
This leads to nicotine acetylcholine receptor desensitization which in turn leads to symptoms of unrest and agitation, driving that motivation for the next cigarette to desensitize the nicotine receptors again.
It becomes a vicious cycle. When the nicotine receptors are sensitive, we seek to desensitize them again by smoking. When you are coping with pain, pain can increase smoking behaviors, but smoking can also increase pain.
So, you might smoke out of the fear that the pain will come back, as well as the desire to achieve the positive effect of nicotine such as increased energy and mild euphoria to cope with that pain.
When chronic pain and smoking are both present, studies have shown that people report more severe pain and greater functional impairment than nonsmokers. Studies also show that there is greater sleep-related impairment and levels of depression.
We know that smoking causes oxidative stress, inflammation, and impairs oxygen delivery which affects recovery and healing after injury, slows the healing process, and puts a person more at risk for infection.
This can lead to an acceleration of degenerative changes and make painful conditions more prominent. Tobacco smoking also has been linked to exacerbating chronic conditions such as back pain, rheumatoid arthritis, headache, and oral pain.
The encouraging news is that quitting smoking reduces the risk and severity of chronic pain, inflammation, osteoporosis, spinal disc deterioration, depression, stress, and anxiety. It also enhances mood and overall life outlook.
So, what do we do? What is the best way to stop smoking when chronic pain is present?
- Look for associations with pain and smoking cues. Are they related?
- Use nicotine replacement therapy and medications to improve quitting prospects, effectively minimizing withdrawal symptoms.
- Explore programs like physical therapy, biofeedback, pain management, and rehabilitation for tools to control pain and regain a fulfilling life. They can also help when tapering off pain medications, such as opiates, which can increase pain due to withdrawal from these substances.
- Seek support from professional counselors, friends, and family who can help with physical and emotional needs.
