What to Do About Chronic Upper Back Pain After Smoking Cessation

Chronic back pain

For most people, smoking cessation improves back pain or makes it easier to treat. However, some people complain of increased pain after quitting smoking. If you develop acute or chronic upper back pain after smoking cessation, there are a number of remedies that can help diminish musculoskeletal pain. If there is no improvement, see your doctor to rule out other causes of your back pain such as lung disease related to your smoking, as well as for additional treatment.

Back Pain and Smoking Cessation

There is no clear explanation for those who complain of increased back pain after smoking cessation. On the contrary, in general, people who quit smoking have less back pain. One study, reported in 2012 in the Journal of Bone and Joint Surgery, found patients who never smoked or quit smoking during a course of treatment for back pain had significantly less pain compared to those who smoked.

Smokers have a higher risk for degenerative changes in the discs in the spine, as well as bone loss in the vertebral bones, which cause a high prevalence of back pain during smoking.

Nicotine and Pain Relief

It is possible that for some people, absence of the pain-relieving effects of nicotine causes them to notice back pain after quitting smoking. According to a 2010 article in the journal Anesthesiology, there is a complex relationship between smoking and pain. On one hand, people who smoke are more likely to have back pain than those who don't; on the other hand, nicotine has been shown to have analgesic effects in animal and human studies through its effect on the spinal cord pain pathway. Chances are without the nicotine, with time and the right remedies your back pain will progressively improve.

Upper Back Pain Home Remedies

Working out

Try any of the following home remedies if you experience upper back or any other site of back pain after quitting smoking. A combination of remedies will be especially effective.


When the upper back pain is new and acute, the first step in trying to relieve it is to reduce moving around and put your back at rest briefly for a day or two. This should help relieve any muscle tightness caused by the origin of the back pain. However, you don't want to limit your activities for too long because this will retard your progressive return to full function. If the pain is chronic, increased physical activity is more helpful.

Ice and Heat

Ice is a great first-line aid for acute pain. It can help reduce any acute pain, swelling, muscle spasm, or inflammation. For chronic pain, heat might be better for pain relief and rehabilitation. Heat reduces muscle tightness and stiffness, increases blood flow to the area, and helps your muscles relax. Apply to your back for 20 to 30 minutes, two to four times a day. You can try alternating ice packs with heat packs. Buy an electric or a microwaveable heating pad and two or three gel packs you can keep in the freezer.

Over-the-Counter Medicines

Try a short course of over-the-counter (OTC) pain medicine like Tylenol, or anti-inflammatory pain medicine like Advil, Aleve, or Motrin. If OTCs don't help, talk with your doctor about prescription medicines.

Vitamin D and Calcium

Both vitamin D and calcium are essential for bone formation. Low vitamin D and calcium levels lead to poor quality bone and loss of bone mass, which can cause chronic bone, joint, and muscle pain. Smoking further leeches calcium from bone as well as decreases its oxygen supply and worsens the pain.

Ensure you are getting enough vitamin D and calcium to improve your bone architecture and mass. Talk to your doctor about appropriate vitamin D and calcium doses.


Stretching or yoga exercises can relieve tension, muscle tightness, and spasms that might be causing your back pain. According to Harvard Medical School's Health Publications, stretching has several benefits, such as keeping your muscles and joints limber and flexible.

Physical Activity

Increase your physical activity as your acute back pain eases. Simply walking for 15 to 20 minutes at least five times a week can increase your endorphins - your body's pain reliever - which may give you some relief from chronic pain.

Walking and other forms of exercise also increase blood flow and oxygen supply to your bones and muscles and help repair the damage from smoking. Physical activities also reduce stress and muscle tension that may be adding to your level of pain.

Stress Reduction

Meditation, deep breathing, imagery, and other relaxation techniques reduce stress and help you to diminish or better cope with acute or chronic back pain. A massage can also be relaxing and stress reducing.


Consider acupuncture for pain relief if home remedies are not helping. According to the National Center for Complementary and Integrative Health (NCCIH), acupuncture by an experienced acupuncturist can relieve pain, including back pain.

Physician Prescribed Remedies

Patient doing some special exercises

If don't get progressive improvement in your back pain from home remedies, or your pain is getting worse, see a doctor for an evaluation and other forms of treatment, which can include:

  • A referral for physical therapy (PT) modalities such as:
    • Ice or heat therapy
    • Stretching and back muscle strengthening exercises; with a post-PT home exercise program
    • Therapeutic massage
    • Ultrasound muscle therapy
    • Water therapy - the buoyancy and other properties of water improves the benefits of various muscle strengthening exercises
    • Transcutaneous electrical nerve stimulation (TENS) therapy - sends electric pulses along nerve fibers and decreases transmission of pain to the brain
  • Prescription-strength pain medicine
  • Prescription anti-inflammatory drugs such as Voltaren (diclofenac) gel
  • Prescription nerve pain medicine such as Lyrica (pregabalin) or Neurontin (gabapentin)
  • A muscle relaxant such as baclofen
  • Trigger point injections - the injection of medicines into small knotted areas of muscle from where the pain originates

Pain Control

Don't let upper back pain after smoking cessation cause you to resume smoking and continue your risk for the many poor health effects of smoking. Treat your pain with any of the several remedies available to you and with time, you will find relief.

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What to Do About Chronic Upper Back Pain After Smoking Cessation