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 Researchers focused on a common cause of lower back pain known as
lumbar spinal stenosis, which occurs when the spinal canal narrows,
putting pressure on the spinal cord and nerves. The condition often
develops as people age, but nicotine’s constriction of blood flow
and promotion of inflammation are believed to contribute to the
process, the study authors write.
The researchers examined data on 331,941 construction workers who
were part of a nationwide occupational health registry in Sweden.
Workers were followed for an average of more than three decades,
starting when they were typically in their 30s, and 1,623 of them
eventually had surgery for lumbar spinal stenosis.
Compared to people who never smoked, heavy smokers who went through
at least 15 cigarettes a day were 46 percent more likely to have
this spinal surgery, the study found. For moderate smokers who had
up to 14 cigarettes a day, the increased risk was 31 percent, while
ex-smokers had 13 percent higher odds of surgery.
“Smoking appears to be a risk factor for developing lower spine
space narrowing that can lead to surgical treatment,” said senior
study author Dr. Arkan Sayed-Noor, a researcher at Umea University.
“Quitting smoking can reduce the risk,” Sayed-Noor said by email.
While some previous research has linked smoking to worse outcomes
from spinal surgery, the current study offers fresh evidence that it
can also increase the odds that back pain will require surgery,
Sayed-Noor added.
Overall, 44 percent of the study participants were non-smokers.
Another 16 percent were former smokers, while 26 percent were
moderate smokers and 14 percent were heavy smokers.
The connection between smoking and spinal surgery persisted even
after researchers accounted for other factors that can increase the
odds of lower back pain such as aging and obesity.
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Smoking damages the spine in several ways, researchers note in The
Spine Journal. Nicotine can damage spinal tissue, weaken bones and
make back pain worse.
Heavy smoking is also often accompanied by a sedentary lifestyle
that may lead to muscle weakness and increase strain on the lower
back.
One limitation of the study is that researchers lacked data on
exercise habits, the authors note. Most of the construction workers
in the study were men, and the results might be different for women.
Still, the findings add to evidence linking cigarettes to disc
damage and back pain, said Dr. Jean Wong, a researcher at the
University of Toronto who wasn’t involved in the study.
“There are multiple short and long-term health reasons for smokers
to quit, and by quitting smoking, smokers can reduce their risk of
back pain due to disc degeneration and spinal stenosis - which can
be a debilitating problem in smokers,” Wong said by email. “Although
it may take multiple attempts, quitting smoking is the best thing a
smoker can do to minimize the risk of spinal stenosis and other
health problems.”
SOURCE: http://bit.ly/2CXnjDL The Spine Journal, online December 12,
2017.
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