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New Research Links Smoking To Back Pain

Updated on July 22, 2014

Over the last half century, study after study has chronicled the health risks associated with smoking, including cancer, heart disease, pulmonary disease, and emphysema, high blood pressure, and stroke. Now researchers say there’s another condition to blame on smoking: back pain. A new study strongly suggests there is a link between smoking and lower back pain. The research also improves the understanding of what causes degenerative lumbar spine problems.

Atherosclerosis - build-up of plaque in blood vessels
Atherosclerosis - build-up of plaque in blood vessels

Smoking Contributes to Atherosclerosis, Plaque Build-up On the Inside of Blood Vessels

The study focused on 1,337 physicians who graduated from John Hopkins University between 1948 and 1964, so researchers tracked some of the participants for more than half a century. Results from the data showed that smoking history, hypertension, and the condition of the coronary artery were significantly associated with the development of low back pain.

In particular, smoking contributes to atherosclerosis, which is when plaque or other material builds up on the inside of blood vessels, decreasing blood supply to areas that are fed by very small vessels, such as the bones and discs of the spine. So atherosclerosis decreases the spine’s ability to heal itself, and over time that can lead to spinal degeneration and the onset of pain.

The spine’s ability to heal is also affected by a specialized cell called an osteoblast that builds bone tissue. Nicotine, the chemical in tobacco that makes smoking addictive, also inhibits the activity of osteoblasts, which inhibit the ability of spinal bones to rebuild. So eventually the bone gets used up faster than it can be rebuilt, leading to osteoporosis and other degenerative conditions that can cause chronic back pain.

Research Shows Smokers Have Less Pain Tolerance

One finding that surprised researchers was that smokers in the study showed less tolerance for pain in general. One theory is that the chemicals in cigarettes interfere with the body’s natural hormonal activity for pain detection, so the smoker feels more pain than a non-smoker.

Research at Curtin University also found an association between smoking and spinal pain. In this case, the data found that back pain experienced at 14 years of age is a significant risk factor for the teenager to start smoking at 17; conversely, smoking at 14 is a good predictor for the teen to develop back pain at 17. The study involved 1,596 14-year-olds and 1,291 17-years-olds.

Researcher Leon Straker says a number of mechanisms have been proposed to explain associations between spinal pain and smoking. “From a biological perspective, smoking has been shown to reduce the amount of nutrition to the intervertebral discs by reducing blood flow to the vertebrae, which in turn may contribute to low back pain and disc degeneration. It has also been suggested that smoking inhibits experience of pain. Smoking may be used to cope with discomfort, which in turn increases pain in the spine, leading to a further increase in smoking.”

Straker adds: “This study begins the exploration of prognostic factors that play a part in the onset of spinal pain or smoking behavior in our young people. Smoking, psychosocial problems, and spinal pain are common in adolescents, with musculoskeletal pain having been shown to have an impact on school and activity participation. Their high prevalence is a cause for concern.”

Smoking & Back Pain - Dr. Thomas Jarecky

Smoking & Back Pain

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