The Link between Smoking and Chronic Back Pain

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Patients suffering with low back pain, sciatica, and herniated discs may want to ditch the smokes if they really want to get out of pain. The reason: cigarette smoking increases risks for developing herniated discs and low back pain. New studies say, the link between smoking and back pain is even stronger in adolescents and young adults.

Cigarettes contain nicotine and other toxins that constrict blood vessels, including those in the spine, which reduce circulation to the low back. These same chemicals may block the body's ability to deliver bone-strengthening, nerve-protecting nutrients to the spine. Smoking is also known to reduce bone density, which leads to osteoporosis and other bone disorders. Poor circulation, weak muscles, and poor bone health are key components to developing back injury.

Finnish scientists published a study in the January 2010 issue of the American Journal of Medicine that reviewed 81 studies (conducted between 1966 and 2009) from around the world involving smokers, former smokers, or never-smokers, and low back pain. Forty of those studies (involving more than 300,000 adults and adolescents) met the criteria for their analysis. The researchers conducted even further analysis to better understand how cigarette smoking increases risks for back pain.

They determined that even though the data did not prove smoking leads to low back pain, it suggested a "fairly modest" association between smoking and low back pain. Adolescents and adults who currently smoked were at 31 percent higher risk of low back pain compared with those who never smoked, and this estimate was only for short-term back pain lasting one day or more during the past 12 months. The strongest association between smoking and low back pain was for chronic or disabling low back pain.

Why does cigarette smoking increase back pain? Research hasn't determined a conclusive cause and affect relationship yet. The National Institutes of Health says although smoking may not directly cause back pain, it increases your risk of developing low back pain and lo sciatica. Sciatica is back pain that radiates to the hip and/or leg due to pressure on a nerve and is sometimes caused by herniated discs. Current theories about why cigarette smoking increases your risk for low back pain include:

  • Cigarette toxins can keep spinal discs from absorbing nutrients, which increases likelihood for disk injury.
  • Repeated coughing from heavy smoking may put excess pressure on the back, which may cause back pain or injury.
  • Smokers are less physically fit and less healthy than nonsmokers, which puts them at higher risk for developing back pain.
  • Smoking increases risk for osteoporosis, which causes weak, porous bones and may cause painful spinal fractures.
  • Smoking may increase low back pain by re-circulating neurotransmitters related to pain sensitivity.

If low back pain, herniated disc or sciatic pain is part of your life, making one big lifestyle change may be the key to long lasting pain relief. Quit smoking. Ask your physician for help to put down the smokes for good.

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National Institutes of Health

Back Pain

The American Journal of Medicine

January, 2010

The Association between Smoking and Low Back Pain: A Meta-analysis

Rahman Shiri, MD, PhD, Jaro Karppinen, MD, PhD, Paivi Leino-Arias, MD PhD, Svetlana Solovieva, PhD, Eira Viikari-Juntura, MD, PhD