4 Ways Smoking Wrecks Your Back

Smoking is well-known to negatively impact one’s health, but did you know it can cause back pain, too? Here’s how.

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We’ve all seen those jarring anti-smoking ads over the years, the ones created by The American Lung Association or American Cancer Society that show longtime smokers with tracheotomies or carrying around oxygen tanks. And although these ads are powerful, people do continue to smoke. In fact, according to the Centers for Disease Control and Prevention (CDC), as of 2016, around 38 million people still smoked every day or some days.

Smoking back painBack pain: Yet another reason to quit smoking.

There are many documented risks associated with smoking. shares, Here’s just a couple:

  • Greatly increased risk of many cancers, especially lung
  • Increased risk of heart disease and atherosclerosis
  • Slower wound healing and increased infection risk after surgery
  • Aggravation of existing health conditions such as asthma

…and more.

Along with these 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,” says Ofer M. Zikel, MD, FACS, Director of Neurological and Spinal Surgery at Wisconsin’s Aurora Medical Center Kenosha. “In my opinion, which is shared by many others, 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.

The Effects on Chronic Pain and the Vascular System

Smoking not only causes back pain—it brings on all-over pain and overwhelms the vascular system—your blood vessels (veins, arteries, and capillaries).

“Primarily, smoking has a bad impact on blood flow and circulation,” explains Ai Mukai MD, physiatrist at Texas Orthopedics, Sports and Rehabilitation Associates in Austin, Texas. “This can damage muscles and tendons as well as the other spinal structures, such as the disc.”

She adds that smokers don’t heal well from injuries, “which means if you injure a disc, it will take smokers longer to heal—or it may not heal at all.”

As for pain elsewhere in the body, Dr. Mukai says that smoking encourages increased inflammation, and that in and of itself can cause pain. Smoking can also interfere with medications that are prescribed to help pain and its absorption and function in the body.  

So, why does smoking lead to pain?

Dr. Zikel says that there are several theories on this, “including the neuroexcitatory role of nicotine, as well as the harmful effects of many of the other chemicals and toxins in smoke damaging the spinal discs and facets, or the joints of the spine.”

Back Pain Conditions Worsened by Smoking

There is a myriad 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,” says Dr. Zikel. He details that dehydrated discs are “likely due to the effects of nicotine on the vascular system as well as the cellular damage caused by smoke toxins.” 
  2. Osteoporosis: Dr. Mukai says, “Smoking is also associated with higher risk of osteoporosis, or thin bones, and this can lead to increased risk of spine fractures.”
  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.
  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. Dr. Zikel says, “I, like 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.”

Beyond pain, smoking can additionally influence mood and sleep quality.

“Smoking has a negative association with three factors—mood, sleep, and pain,” Dr. Mukai says. “It's a negative, vicious cycle, since people who are depressed, have pain, or experience anxiety tend to smoke more to cope in an unhealthy way, which then leads to worse pain and health.” She adds that depression, anxiety, and other mood disorders have been found to have a negative impact on spine surgery outcomes.  

How to Quit Smoking for Good

Have all of these facts convinced you to quit smoking? We really hope so. If so, you should know that it absolutely can be done, with the right resources.

“There's just nothing good that comes out of smoking,” Dr. Mukai asserts, adding that quitting smoking can help with pain in the long run. She believes that several therapies can help someone quit smoking, such as medications, cognitive behavioral therapy, and she’s also seen good results from hypnosis and acupuncture.

“There are many reasons to quit smoking today,” Dr. Zikel says. “Quitting not only increases your lifespan, but the quality of life, with less risk of chronic disease and pain. I recommend that those who want to quit talk to their primary care physicians about a treatment plan which, depending on the individual, can include nicotine replacement therapy, counseling, and support.”

He shares a final thought, saying, “As I tell my patients, smoking cessation is one of the greatest achievements of your life.”  

Updated on: 10/27/20
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Ai Mukai, MD
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Your Spine on Nicotine

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