I believe if we love and respect our bodies, they will love and respect us back.  Let’s review the biblical story of Daniel, Shadrach, Meshach, and Abed-nego.  After being taken captive into Babylon, these four Jewish boys were brought to the king’s house and offered the king’s meat (probably pork) and wine.  Wanting to obey the commandments of God, Daniel and his friends worked out a deal with the king’s servant. He would conduct an experiment: feed them grains and water for ten days and see if they were any worse off than their peers.  At the end of that time, they appeared healthier than the rest.

Outside of the spiritual implications of this story, we can view this as a great cohort study where one group received the intervention (grains and water) and the control group was fed what everyone else ate, with an obvious outcome.  This may be the first of many such studies showing that eating healthy foods and abstaining from unhealthy substances can improve our health.  

Let’s examine the ways in which various substances can impact musculoskeletal health.  

Nicotine

Muscles, tendons, and joints receive their nutrient and oxygen supplies from the same place as every other tissue: arteries.  Inhaling tobacco smoke has several physiological effects.  First, the carbon particulates in the smoke get into the small airways of our lungs where oxygen exchange occurs.  Through multiple mechanisms, the airways are damaged, and oxygen uptake is impaired.  This decreases available oxygen to our musculoskeletal systems.  Cartilage deteriorates, microtears occur in tendons, and soon we are more susceptible to injury and further degeneration.  A 2025 study identified an increased risk for disability, including mobility-related conditions, in those who currently smoke.

In addition, nicotine is a vasoconstrictor, meaning it narrows arteries when it enters the bloodstream.  This leads to increased blood pressure and faster blood movement through arteries. Nutrients have less time to make their way into tissues.  This happens whether a person gets his/her nicotine from vaping, smoking cigarettes, or using nicotine gum.  In no way does nicotine benefit bones and joints.

Alcohol

The interplay of alcohol on the musculoskeletal system is complex. Alcohol can decrease pain for a time through neurological pathways. It has been touted as an antioxidant, removing soreness and reactive chemicals from tissues. These findings have led some to conclude alcohol is good, not just for bones and muscles but for overall health.

In my mind, these benefits are narrow interpretations of the research. Alcohol is an empty carbohydrate, making people feel full when they have not eaten anything nutritious. This results in relative malnutrition, depriving tissues of building blocks necessary for recovery. Alcohol has known addictive and mood-altering properties. Robust research has firmly linked alcohol use with decreased athletic performance and (even worse) cancer incidence. When we think of the supremely negative effect alcohol can have on individuals, homes, and communities, application as a pain treatment becomes non-sensical.

Marijuana

There has been an incredible increase in the last fifteen years in the acceptance of marijuana for pain management, but let’s review the evidence.  According to a study published in the Journal of the American Medical Association, cannabis relieved pain no better than placebo. Comparing marijuana use to exercise, sweating a little for thirty minutes a day promises far greater improvements in pain and function.  

Outside of marijuana’s negligible impact on pain, we have excellent, overwhelming evidence it negatively impacts developing brains, decreases motivation and function, impairs driving, and has the same effect on lungs as smoking tobacco.  More recent studies demonstrate a 40% increased risk of stroke in daily users.  If any FDA-reviewed medication did that, it wouldn’t make it past safety trials.  So, in response to the cries for marijuana’s inclusion as a pain control option, I cry just as loudly: Go take a lap instead. 

In summary, nicotine, alcohol, and marijuana do no favors for our musculoskeletal systems and can result in damage.  Such has been verified by scientific research and individual experience.  Let’s be like Daniel and his friends by treating our bodies well. Avoiding harmful substances can help us become “ten times better” (1 Daniel 1:20) and lead to longer, healthier lives.

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References:

1. Novakovich J, Griffin T, Armour B, et al. Estimating the prevalence of disability among adults in the USA who smoke cigarettes, 2019–2023. Tobacco Control. Published Online First: 29 May 2025. 
2. Alcohol and cancer risk. NIH National Cancer Institute. Retrieved from the World Wide Web on June 17, 2025, at https://www.cancer.gov/about-cancer/causes-prevention/risk/alcohol/alcohol-fact-sheet.
3. Gedin F, Blomé S, Pontén M, et al. Placebo Response and Media Attention in Randomized Clinical Trials Assessing Cannabis-Based Therapies for Pain: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022;5(11):e2243848. 
4. Jeffers AM, Glantz S, Byers AL, Keyhani S. Association of Cannabis Use With Cardiovascular Outcomes Among US Adults. J Am Heart Assoc. 2024 Mar 5;13(5):e030178.