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Smoking is a risk for chronic low back pain

Smoking is a risk for chronic low back pain

Spinal disorders are among the leading causes of disability. These represent one of the biggest health problems in modern society, as between 60% and 80% of the population will suffer from back pain. Not being able to move properly due to pain affects our quality of life, our ability to work and our relationships with those around us. The population most vulnerable to low back pain are people who have a job with physical demands, people with emotional stress, people with a history of injuries, smokers or overweight.

There are different studies that associate low back pain with being a smoker. Today I would like to tell you in more detail how smoking tobacco is a risk factor for low back pain.

We already know that tobacco harms our health in different ways and it is best to avoid it, however we are not used to feeling that it can be a trigger for low back pain.

Smoking has become a habit that can trigger back pain and increase the risk of low back pain. Different explanations have been given to give rise to this association.

Smoking causes general damage to the tissues of our musculoskeletal system due to vasoconstriction, hypoxia and other mechanisms that prevent or hinder the access of nutrients and therefore worsen the condition of body structures.

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If we focus on the spine, smoking can cause intervertebral disc herniations due to coughing, or pathological changes in the disc itself. These changes are due to alterations in the nutrients that the disk receives, its pH or its mineral content. This accelerates disc degeneration leading to spinal instability and consequently disc herniations, sciatica and low back attacks occur. Disc degeneration in smokers is shown to be more severe than in non-smokers.

Alteration of the metabolic activity of the different components of the intervertebral disc and the ligaments of the spine in smokers: they increase the process of disc degeneration and weaken the ligaments of the spine causing instability. This would increase the risk of low back pain in smokers.

Smoking also has a central effect, on the interpretation of the brain, on the perception of pain. Nicotine is a psychostimulant that affects the cortex of the brain and the regulation of our autonomic nervous system. This means that it can affect the way the brain processes information from sensory stimuli and the perception of pain.

Different studies have shown that there is a relationship between cigarette smoking and symptoms of chronic pain. Comparing smokers and non-smokers, there is an increase in musculoskeletal pain in different parts of the body and only in the back. The different symptoms that smokers suffer from are pain: in the arms, wrists, shoulders, legs, hips, knees, headaches, fibromyalgia, sciatica, generalized pain in the joints, generalized pain throughout the body and fatigue.

In smokers there is a higher risk that the pain will become disabling rather than just pain.

DID YOU KNOW THAT… The association between regular smokers and the incidence of low back pain is stronger in adolescents than in adults?

Smoking has been linked to persistent low back pain in young adults. Smoking at age 16 was associated with chronic low back pain, especially in girls. A study conducted in 2009 in Canada, with 73,000 people between the ages of 20 and 59, looked for the relationship between being a smoker and low back pain. The prevalence of low back pain in regular smokers was 23.3% and in non-smokers 15.7%. The association between being a regular smoker and the risk of chronic low back pain depended on age. It was found that the risk of suffering from chronic low back pain was higher in young people.

Article published in collaboration with Cindy Vilahur, a chiropractor in Palafrugell, at her 360 Chiropractic Center. If you want more information about chiropractic you can contact her through her website:

Hiroshi Oda, et al. Degeneration of intervertebral discs due to smoking: experimental assessment in a rat-smoking model. Journal of Orthopedic Science 9, 135-141 (2004)

Leboeuf- Yde, Charlotte, DC, MPH, PHD. Smoking and low back pain: A systematic literature review of 41 journal articles reporting 47 epidemiologic studies. Spine: July 15, 1999- volume 24- Issue 14 – P1463.

Mitchell D. M. Et al. Association of smoking and chronic pain syndromes in Kentucky Women. The Journal of Pain. Volume 22, Issue 8, August 2011, Pages 892-899.

KT Palmer, et al. Smoking and musculoskeletal disorders: findings from a British national survey. Ann Rheum Dis 2003; 62: 33-36.

R.R. Fogelholm et al. Smoking and intervertebral disc degeneration. Medical Hypotheses. Volume 56, Issue 4, April 2001, Pages 537-539.

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