Nicotine in cigarettes improves pain but doctors don't recommend smoking for chronic pain patients. Studies show that patients with neuropathic (nerve-related) pain are more likely to smoke than patients with nociceptive pain. Nociceptors are pain receptors that detect mechanical, thermal, or chemical changes. Another word for this structure is nerve ending.
It's not clear if smoking is more common among patients with neuropathic pain as a way to self-medicate or if this connection is just by chance. And although smoking can improve pain, there does not appear to be a clear link between pain level and number of cigarettes smoked (frequency).
Doctors encourage all patients to quit smoking. There are many health benefits from quitting tobacco use. No one knows for sure if quitting smoking would increase or decrease pain levels. Studies do not show that greater pain intensity leads to more frequent use of tobacco as might be expected.
Even though smoking can improve pain, smokers still tend to have greater pain intensity. They also report interference with mood and sleep because of pain. Results of treatment are less successful among smokers with chronic pain compared to nonsmokers. Future studies plan to look at the link between pain, smoking, and thoughts of suicide.
Anne Jacobson. Neuropathic Pain Sufferers More Likely To Smoke. In Pain Medicine News. June 2008. Vol. 6. No. 6.'