Cigarettes in an Ashtray

By now, most people understand that smoking cigarettes has many negative health benefits, but one surprising side effect of smoking is joint pain.1,2

A study published in Annals of the Rheumatic Diseases involving 13,000 people found that smoking made individuals more vulnerable to pain by about 30 percent.3 Even though only about 18 percent of Americans smoke, over 50 percent of patients who seek treatment for pain are smokers.4,5

This is how smoking relates to joint pain and the types of pain that are most common among long-term smokers.

Why Smoking Causes Pain

Studies suggest that smoking cigarettes changes the way that the brain processes sensory stimuli and perceives pain.6 Nicotine tricks the body into feeling less pain at first and releases feel-good chemicals like dopamine, which is why smoking has an addictive quality.7 Smokers may be less aware of the pain their body is experiencing until that feeling wears off.

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Not only can cigarettes change how the brain sends pain signals, but they can also hinder the body’s circulatory system and prevent nutrients from flowing to the muscles and joints. Certain types of pain, like back pain, may be exacerbated by the symptom of coughing that many smokers have. Finally, the risk of developing rheumatoid arthritis becomes greater if one is a smoker and genetically predisposed to the autoimmune condition.1

Types of Pain Smokers Feel

In the Annals of the Rheumatic Diseases study referenced above, the most pronounced type of pain that smokers felt was back pain.3 However, this wasn’t the only type of pain reported from the surveys. Neck, shoulder, hip, knee, hand, and elbow pain were also more common in smokers than non-smokers.

Also, individuals who already have joint conditions like osteoarthritis experience more severe pain and loss of bone cartilage if they are smokers. Another study involving 159 men with symptomatic knee osteoarthritis found that on a pain scale of one to 100, smokers reported an average pain score of 60 and non-smokers just 45.8 To explain this increase in knee pain, the researchers hypothesized that smoking may increase oxidant stress to destroy cartilage, inhibit cell proliferation, and increase carbon monoxide in the blood to prevent cartilage repair.

Healthy Alternatives to Smoking

It may come as a surprise to smokers that their habit could be causing pain or making existing pain worse. Simply realizing and understanding this may be enough to help smokers reconsider their choices. Smokers can treat the symptoms of their pain with physical therapy and arthritis relief creams like JointFlex. But quitting smoking once and for all is the best way to prevent pain and many other health problems.

Smokers must find alternative coping mechanisms to deal with pain and stress and take the place of cigarettes in daily life. Oftentimes simply going for a walk or other form of exercise can bring relief and distract the mind from cigarette cravings. It is advisable to join a support group, surround oneself with positive individuals, and to discuss smoking cessation methods with a trusted doctor. Quitting smoking is never easy, but it is always worth it for health, wellness, and longevity.

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1. Health effects of cigarette smoking. Centers for Disease Control and Prevention. Retrieved October 19, 2018 from
2. 5 Reasons Smoking Makes Arthritis Worse. Arthritis Foundation. Retrieved October 17, 2018 from
3. Palmer, K. T., Syddall, H., Cooper, C., & Coggon, D. (2003). Smoking and musculoskeletal disorders: findings from a British national survey. Annals of the Rheumatic Diseases, 62, 33-36. Retrieved October 18, 2018 from National Center for Biotechnology Information
4. Current cigarette smoking among adults in the United States. Centers for Disease Control and Prevention. Retrieved October 18, 2018 from
5. Ditre, J. W., Brandon, T. H., Zale, E. L., &  Meagher, M. M. (2011 November). Pain, nicotine, and smoking: Research findings and mechanistic considerations. Psychological Bulletin, 137, 1065-1093. Retrieved October 18, 2018 from National Center of Biotechnology Information
6. Petre, B., Torbey, S., Griffith, J. W, De Oliveira, G., Herrmann, K., Mansour, A., Baria, A. T., Baliki, M. N., Schnitzer, T. J., & Apkarian, A. V. (2018 August). Smoking increases risk of pain chronification through shared corticostriatal circuitry. Human Brain Mapping, 36, 683-694. Retrieved October 17, 2018 from National Center of Biotechnology Information,-joint,-and-muscle-disorders/hand-disorders/carpal-tunnel-syndrome.
7. Cigarettes and other tobacco products. National Institute on Drug Abuse. Retrieved October 18, 2018
8. Amin, S., Niu, J., Guermazi, A., Grigoryan, M., Hunter, D. J., Clancy, M., LaValley, M. P., Genant, H. K., & Felson, D. T. Cigarette smoking and the risk for cartilage loss and knee pain in men with knee osteoarthritis. Annals of the Rheumatic Diseases, 66, 18-22. Retrieved October 18, 2018 from National Center of Biotechnology Information