Does Smoking Cause Low Back Pain?
By: Donald J. Frisco MD
This idea has been around for quite some time. As a matter of fact there are many surgeons who won’t do operations on patients who smoke because the surgical outcomes are so negatively affected by smoking!
When you smoke, nicotine reaches the brain in about 10-20 seconds. This causes a chemical called dopamine to be released in the brain. Dopamine provides a feeling of pleasure.
A new study strengthens the link between smoking and lower back pain, and also sheds light on the causes of degenerative lumbar spine problems.
The study on smoking and low back pain, which prospectively examined 1,337 physicians who graduated from Johns Hopkins University between 1948 and 1964, followed some participants for more than 50 years. Researchers discovered that smoking history, hypertension and coronary artery disease—all of which are risk factors for atherosclerosis, or occlusion of the arteries—were significantly associated with the development of low back pain.
These same risk factors, along with abnormally high blood cholesterol levels, were also significantly associated with the development of lumbar spondylosis. The findings provide support for the hypothesis that atherosclerosis causes lower back pain and degenerative disorders of the intervertebral discs.
Smoking and low back pain study results
The study results, which were reported at the 2001 annual meeting of the American Association of Orthopaedic Surgeons in San Francisco, lend support to the theory that the mechanism of injury in low back pain is damage to the vascular (blood supply) structures of the discs and joints.
Numerous researchers have proposed a link between smoking and low back pain, but the exact nature of that link had remained largely untested in terms of long-term prospective studies. "Because we had the subjects' medical records and answers from self-reported questionnaires over such a long period of time, a 53-year period of time for the oldest patients, we were able to determine if the risk factors, such as smoking or high cholesterol, preceded the development of the disease years later," said Nicholas U. Ahn, Chief Resident in the Department of Orthopedic Surgery at the Johns Hopkins Hospital in Baltimore and co-author of the study.
"To prove a causative association from a long-term prospective study is very powerful because one can show that the cause occurred before the effect as opposed to the other way around," Dr. Ahn explained.
Conclusions from smoking and low back pain study
The study concluded that development of lower back pain was significantly associated with smoking history and hypertension, and development of lumbar spondylosis (degeneration of the spine) was significantly associated with smoking history, and hypertension and high cholesterol. No significant association was reported between diabetes and lower back pain or lumbar spondylosis.
Why Smoking Causes Back pain
- Smoking can cause sore back muscles either directly or indirectly. Smoking clogs up the arteries that impair the supple of blood and oxygen to the lower spine. This deteriorates the spinal discs.
- Smoking blocks the body's ability in delivering nutrients to the discs of the lower back. With inadequate nutrition the tissues of the lower back get damaged, which finally results in back pain.
- Nicotine from cigarettes affects the way the brain sends its pain signals.
- Heavy smoking leading to chronic coughing also causes back pain, indirectly.
- Smokers who are less physically fit than nonsmokers have more risk of developing back pain.
- Smoking significantly slows down the healing process, prolongs pain for people with back injuries, broken bones, or who have undergone back surgery.
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