Study explores link between rheumatoid arthritis widespread pain and smoking

A vast majority of patients with rheumatoid arthritis reports widespread pain or severe pain regardless of smoking status, a new study found.

A team of researchers at the Karolinska University Hospital Huddinge in Stockholm, Sweden wanted to investigate if smoking status at the time of rheumatoid arthritis diagnosis was linked with pain spread or intensity.

Published in the journal Nursing Open, the study shows that a large number of patients with rheumatoid arthritis report widespread pain or severe pain, regardless if they smoke or not. The study highlights that smoking has no effect on pain intensity among rheumatoid arthritis patients.

Rheumatoid arthritis in the hands. Image Credit: Hriana / Shutterstock
Rheumatoid arthritis in the hands. Image Credit: Hriana / Shutterstock

To arrive at their findings, the researchers studied 78 patients, with 16 smokers, 38 who never smoked, and 24 had quit smoking. The patients, who were newly diagnosed to have rheumatoid arthritis, were assessed on their pain intensity, disease, activity, and widespread pain. Those who are currently smoking, use up to 15 cigarettes per day and have been smoking for an average of 43 years.

The researchers found that there was no difference between the smoking groups and the average pain duration reported was seven months, with an estimated 31 percent experienced pain for more than a year. Further findings revealed that many patients, as much as 56 percent, had unacceptable pain and 77 percent a high prevalence of widespread pain. Moreover, 28 percent of the patients had chronic widespread pain at the time of being diagnosed with rheumatoid arthritis.

The findings show that pain in rheumatoid arthritis may not be due to smoking, and the researchers hope further research will push through, exploring the possible reasons why there is widespread and severe pain in patients with RA.

“In this study of patients with early RA, there was a high frequency of patients with unacceptable pain and widespread pain, irrespective of smoking status,” the researchers concluded in the study. “However, pain intensity correlated positively with disease activity, why we cannot exclude that the inflammatory‐associated pain overshadowed a possible effect of smoking. Additional studies are needed to solve this issue as an important issue in rheumatology care is to help smokers quit smoking,” they added.

What is rheumatoid arthritis?

Rheumatoid arthritis is a very painful disease affecting the joints. The Centers for Disease Control and Prevention (CDC) describes rheumatoid arthritis (RA) as an autoimmune and inflammatory disease. This means that the body’s immune system is attacking the healthy cells, causing painful swelling. In this case, the body attacks the cells in the joints.

One characteristic of rheumatoid arthritis is that it can cause inflammation in many joints at once. Usually, the disease affects the joints in the wrists, knees, and hands. Joints with RA may have inflammation in the lining, causing joint tissue damage. As a result, the swelling can cause severe and chronic pain, lack of balance, and in some cases, deformity.

In some cases, rheumatoid arthritis may also cause swelling in other parts of the body, such as the eyes, lungs, and heart.

What are the signs and symptoms of rheumatoid arthritis?

The common signs and symptoms of rheumatoid arthritis include pain in more than one joint, joint stiffness, symptoms occurring in both joints, weight loss, tenderness and swelling, fatigue, fever, and weakness.

Across the globe, an estimated 0.3 to 1 percent people have rheumatoid arthritis, and it’s more common in women. In the United States, approximately 1.3 million adults have rheumatoid arthritis, representing about 0.6 percent of the population in 2005. In 2011, about one in 12 women and one in 20 men has been projected to develop an inflammatory autoimmune rheumatic disease in their lifetime.

Due to chronic pain and swelling, many people with rheumatoid arthritis can’t hold a full-time job.

Journal reference:

Karlsson, M.R., Elkan, A.C., and Hafström, I. (2019). Widespread pain and pain intensity in patients with early rheumatoid arthritis. A cross‐sectional comparison between smokers and non‐smokers. Nursing Open.

Angela Betsaida B. Laguipo

Written by

Angela Betsaida B. Laguipo

Angela is a nurse by profession and a writer by heart. She graduated with honors (Cum Laude) for her Bachelor of Nursing degree at the University of Baguio, Philippines. She recently completed a Master's Degree where she specialized in Maternal and Child Nursing and is now working as a clinical instructor and educator in the School of Nursing at the University of Baguio.


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