Smoking, Alcohol, & Obesity: 3 Big Risk Factors for Chronic Pain

October 15, 2021

chronic pain risk factors Chronic pain is a complicated, often confusing condition. We are still learning more and more about causes, treatments, and risk factors. But there are three major risk factors we already know a good bit about when it comes to chronic pain, and those are smoking, consuming alcohol (especially in excess), and being obese.

Major Risk Factors for Chronic Pain

There is much that’s not in your control when it comes to chronic pain. Injuries, conditions or diseases, how your body does or does not heal, and how it does or does not react to treatments. But you can control these three risk factors.


Most studies show that the smoking rate in pain populations is higher than in the general population. Heavy smokers tend to report more locations of pain and also increased pain intensity compared with those who have never smoked. 

Smoking is one of the big picture medical factors when it comes to pain. The nicotine in tobacco tricks the body into feeling better, but only initially. It triggers the release of chemicals, like dopamine, which give off a satisfying sensation. This is what makes smoking so addictive. Nicotine is also a pain-killer, but again, the short term effect is overwhelmed by the long term impact on pain and health in general.

Physicians also link smoking with fatigue and slower healing. These factors can make painful conditions even worse. Another important factor to note is that smokers aren’t typically good candidates for surgery. If you need an implantable device to help with your chronic pain, smoking makes it much more difficult to fight off potential infection from surgery.


A study conducted by the National Institute on Alcohol Abuse and Alcoholism found that 28% of individuals who battle chronic pain turn to alcohol in hopes of relieving their discomfort. In our society, it is unfortunately fairly common to try to alleviate pain or self-medicate with alcohol. This is a very dangerous thing to do.

The reason why this is so dangerous is due partly to the nature of chronic pain. It is defined as pain lasting more than three months. It’s long-lasting and can become more severe over time. If someone self-medicates with alcohol, this person will likely feel the need to continue using it for an extended period of time. They will also most likely feel the need to use more and more alcohol if their pain increases. This cycle can quickly progress toward alcoholism.

As people self-medicate with alcohol, they also may take over-the-counter or prescription medications, which is also extremely dangerous. Many of these carry warnings not to take the medication. Combining the two raises the risk of potentially deadly liver failure. Drinking alcohol while taking aspirin increases the risk for gastric bleeding. The combination of alcohol and opioid painkillers can be deadly as well. Alcohol increases the risk of serious respiratory depression with opioids. 


Both chronic pain conditions and obesity are major public health concerns. The relationship between increased body mass index (BMI) and chronic pain in adults seems intuitive and may be related, in part, to increased weight-bearing on joints, reduced physical activity, and deconditioning. 

Researchers recognize that the relationship between obesity and chronic pain is complex. For example, for someone with arthritis, a chronic health problem, they may not feel well enough to exercise or move around much. This can contribute to weight gain and other problems down the road. On the other hand, it may be that someone starts out overweight, which puts strain on the joints, leading to joint problems that cause pain.

In fact, one of the factors leading to increased incidence of chronic pain in obese patients is the increased weight on joints and the spine. Higher body mass index is associated in arthritis research with greater defective change in knee cartilage and joint space widths.

An anti-inflammatory diet can help with weight loss and chronic pain conditions. This type of eating should include a healthy balance of protein, carbs, and fat at each meal. It’s also important to meet the body’s needs for vitamins, minerals, fiber, and water. 

We recommend that you work with your doctor at Southside Pain and/or a dietician on a plan that is tailored to you. Again, unless you have a specific condition that suggests otherwise, adding in more of these anti-inflammatory foods to your diet will always be beneficial. 

Our doctors and staff can also advise you on getting help to quit smoking or stop drinking. We have many resources available to you, and a multi-tailored approach to treating your chronic pain will likely have the greatest effect. 

Start your pain management journey by scheduling an appointment at Southside Pain Specialists

With highly specialized training and a multitude of pain relief options, Southside Pain Specialists follow the standards of the American Society of Interventional Pain Physicians, The American Board of Pain Medicine, and the International Spinal Injection Society. We work hard to provide patients with comprehensive, caring pain relief when they need it most. Check out our website or contact us today at 205.332.3155 to learn more.