We all know the line. Smoking kills! But how does it affect your back?
Let’s analyze how big a problem is smoking first.
Smoking leads to disease and disability and harms nearly every organ of the body.
- For every person who dies because of smoking, at least 30 people live with a serious smoking-related illness.
- Smoking causes cancer, heart disease, stroke, lung diseases, diabetes, and chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis.
- Smoking also increases risk for tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.
- Smoking is a known cause of erectile dysfunction in males.
Smoking is the leading cause of preventable death.
- Worldwide, tobacco use causes more than 7 million deaths per year. If the pattern of smoking all over the globe doesn’t change, more than 8 million people a year will die from diseases related to tobacco use by 2030.
- Cigarette smoking is responsible for more than 480,000 deaths per year in the United States, including more than 41,000 deaths resulting from second hand smoke exposure. This is about one in five deaths annually, or 1,300 deaths every day.
- On average, smokers die 10 years earlier than nonsmokers.
Did you know that smoking can affect your back too?…
Along with the above dire outcomes, smoking can also greatly exacerbate back pain.
Many people know that smoking cigarettes can cause lung cancer or heart disease, but most people are not aware that smoking is also bad for your back. Smoking greatly contributes to the incidence and severity of low back pain in the community.
If you are currently smoking and experiencing back pain, among other health concerns, read on to learn even more information on smoking, back pain, and how it affects your body.
1. The Effects on Chronic Pain
Smoking not only causes back pain—it brings on all-over pain and overwhelms the vascular system—your blood vessels (veins, arteries, and capillaries).
In a 2010 study that examined the pathophysiology between smoking and pain. Findings indicated that long-term smoking causes receptor desensitization, creating the perception in smokers that a relatively small amount of pain is severe (Anesthesiology. 2010;113[4]:977-92).
Furthermore, smoking deprivation – either caused by a longer-than-usual amount of time between periods of intake or attempts to quit – causes patients to have shorter pain latency.
Structural damage caused by smoking can lead to increased risk of osteoporosis, lumbar disk disease, and impaired bone and wound healing, along with impaired oxygen delivery, the investigators concluded in the 2010 study.
Several other studies confirm these findings including a pair concluding that smoking is associated with higher lifetime risk of musculoskeletal pain (Ann Rheum Dis. 2003;62[1]:33-6), as well as higher intensity of pain (Scand J Rheumatol. 1997;26[1]:49-54).
Additionally, smoking can alter the effectiveness of opioids prescribed for pain management. Smokers have higher pain scores and higher opioid use, but lower serum hydrocodone levels.
This may suggest an up-regulation of the metabolic pathway for morphine. Meaning, these patients end up with taking increased dose of these medications and hence entering a vicious cycle.
Regarding lower back pain, smoking has been found to cause nicotine-associated disk degeneration, according to a 2013 study (Muscles Ligaments Tendons J. 2013;3[2]:63-9). A separate study calculated odds ratios for smokers developing lower back pain as 1.49 for those simply “seeking care,” 1.79 for those experiencing chronic lower back pain, and 2.14 for smokers experiencing severe lower back pain (Am J Med. 2010;123[1]:87 e7-e35).
The most telling study, however, was a 2012 prospective review of 5,322 patients, which found that patients who never smoked experienced significantly less pain than those who did, and that patients who quit smoking over the course of their pain management treatment experienced better outcomes than patients who continued smoking (J Bone Joint Surg Am. 2012;94[23]:2161-6).
In other words, the pain smokers experience are exacerbated or they are more sensitised to the pain.
In addition, the pain killers become less effective in their usual doses and they tend to depend on higher doses thus entering a vicious cycle.
Not to mention the damage it causes the intervertebral disc and joints. If a smoker has an injured disc , it will take longer to heal—or it may not heal at all.
2. The Effects on the Vascular System
Nicotine contributes to atherosclerosis, or narrowing of the arteries. Narrowed arteries restrict blood flow through the body, including to joints and disks of the spine.
The musculoskeletal system is an organ that requires nutrients, blood flow, oxygen, just like any other organ of the body. Impaired circulation accelerates degeneration of the disks, the soft, shock-absorbing pads between the bones, or vertebrae, of the spine.
Back Pain Conditions Worsened by Smoking
There are a variety of painful conditions, from desiccated discs to osteoporosis, that are either caused or worsened by smoking. Some procedures can also be jeopardized due to smoking.
1. Degenerative Disc Disease:
Smoking is linked to the development of degenerative disc disease, otherwise known as disc dehydration among other terms.Dehydrated discs are likely due to the effects of nicotine on the vascular system as well as the cellular damage caused by smoke toxins. Degeneration happens in all of us as we age,but in smokers this process is accelerated and there’s no turning back the clock.
2. Osteoporosis:
Smoking is also associated with higher risk of osteoporosis, or thin bones, and this can lead to increased risk of spine fractures and other region fractures especially the hip.
3. Fibromyalgia:
According to a Mayo Clinic study, smokers with fibromyalgia reported an increased severity in their symptoms, a worse quality of life, and increased anxiety when compared to non-smokers with fibromyalgia. These patients usually end up with chronic pain and disability
4. Spinal Fusion:
When it comes to smoking and spinal fusion, it’s known that smoking can delay or prevent healing and fusion, something that can be quite detrimental when trying to permanently connect two or more vertebrae in one’s spine. Actually, it can negatively affect spine surgeries in general.
Many surgeons, require smoking cessation prior to some spine operations, especially ones involving spinal fusion. There is extensive data that shows smoking negatively impacts fusion of bones, which can lead to worse surgical outcomes.
QUIT…
There’s just nothing good that comes out of smoking and quitting smoking can help with pain in the long run. There are several therapies that can help someone quit smoking, such as medications, cognitive behavioural therapy, and sometimes even hypnosis and acupuncture.
Quitting not only increases your lifespan, but also the quality of life, with less risk of chronic disease and pain.
Those who want to quit should talk to their primary care physicians about a treatment plan which, depending on the individual, can include nicotine replacement therapy, counselling, and support.
Believe you can quit and you’re halfway there! See you soon with some more spine tips in My Spine World. Remember, we got your back !