What to Know About The Connection Between Smoking and Your Back Pain

What to Know About The Connection Between Smoking and Your Back Pain

If you are a smoker, you have most likely been warned about the health risks associated with smoking at some point. The list is topped by heart disease, cancer, and other serious illnesses. But, did you know that back pain is also on the list?

Smoking is commonly associated with back pain, according to healthcare professionals. And research backs this up.

A Finnish review of 40 studies published in the January 2010 issue of the American Journal of Medicine found that current smokers were 1.16 times more likely than non-smokers to have had low back pain in the previous month, and 1.26 times more likely in the previous year.

Women may be particularly vulnerable. Women who smoke, even if only infrequently, appear to be at an increased risk of back pain.

Don't forget about teenagers. The study discovered that teen smokers were 1.82 times more likely than adults to suffer from low-back pain.

Smoking and Spinal Discs

How much smoking can you tolerate before experiencing back pain, and what kind of back pain will you experience? Smoking is a risky business for people who smoke 50 packs or more per year, especially if they are under the age of 45.

The AAOS reports a link between the number of pack-years smoked and the development of herniated discs, as well as the progression of spondylolisthesis, an earlier onset of inflammation, and decreased functioning and quality of life in long-term smokers.

While smoking is likely to have a negative impact on many spinal structures, discs in particular suffer greatly.

Smoking accelerates the degeneration of discs. Chronic coughing, which many smokers experience, can also cause increased pressure on discs.

Tobacco use reduces the exchange of substances necessary for healthy discs, including oxygen. It constricts the arteries that supply the spinal vertebral arterial supply, which can obstruct the process of delivering nutrition to the disc.

Smoking and Back Surgery

A spinal fusion involves the placement of bone or bone-like material between two ailing vertebrae in order to stimulate their union. The bones fuse during the 3-4 month period following surgery, which doctors and researchers refer to as "healing." This is a somewhat perilous time because the vertebral union is not guaranteed. According to the Scoliosis Research Society, at least 5 to 15% of spinal fusions fail to heal.

And guess what is at the top of the list of causes of spinal fusion failure? Smoking. In fact, some surgeons refuse to operate on smokers unless doing so would endanger their life. Others advise patients to stop smoking before having surgery.

Post-Operative Complications

According to the AAOS, smoking may be the single most important factor in postoperative complications, citing poorer outcomes and more frequent complications in smokers following spine surgery. They claim that this is true for any type of spine problem for which surgery is performed, such as spinal stenosis, vertebral fractures, or cervical spine decompression and fusion. Furthermore, the AAOS claims that patients' tobacco use frequently predicts the occurrence of post-operative infections.

Smoking Cessation for a Healthier Back

According to the AAOS, smoking may be the single most important factor in postoperative complications, citing poorer outcomes and more frequent complications in smokers following spine surgery. They claim that this is true for any type of spine problem for which surgery is performed, such as spinal stenosis, vertebral fractures, or cervical spine decompression and fusion. Furthermore, the AAOS claims that patients' tobacco use frequently predicts the occurrence of post-operative infections.

The Bottom Line 

The good news is that the effects of smoking on the spine can be reversed in part. That is, if you stop smoking, you may notice that you have less back pain. While the Finnish study found that people who had successfully quit smoking had more back pain than those who had never smoked, former smokers had less back pain than current smokers.

According to the AAOS, patients who quit smoking for at least four weeks prior to their spinal surgery had fewer complications with wound healing.