By Dr. Hamid Mir | Special to the NB Indy
By now, most of us have seen the PSAs repeatedly. We already know that cigarette smoking is the cause of one in every five deaths in America due to cancer and respiratory disease. Yet, for an estimated 40 million current U.S. adult smokers, those statistics aren’t enough to discourage the habit. They’ve either become numb to the facts or believe they have plenty of time to quit before something really happens to them.
What smokers may not know, however, is that their habit is already affecting them in less obvious though equally critical ways.
Take the spine. Research supports that smokers are more likely to suffer from chronic back pain than nonsmokers. Why?
This is your spine on smoking…
Our vertebrae are held together by discs—slices of fibrocartilage that function like mini shock absorbers, cushioning our spines as we move. It’s important to note that these discs are not very vascular structures and, in general, smoking decreases the profusion and blood flow to organs. Regular smokers essentially starve their discs by further reducing the already tenuous blood flow, which may result in disc degeneration, one of the most common causes of low back and neck pain.
When our discs degenerate, we lose that cushion between vertebrae, our spines lose flexibility and we may experience bone spurs that pinch nerve roots, causing pain or weakness.
Disc generation (also known as degenerative disc disease) is part of the normal aging process for some, but smoking actually hastens the onset and exacerbates the rate of degeneration in those currently suffering.
In other words, not only can smoking cause chronic back pain at a much younger age, but the smoker who is already battling degenerative disc disease only makes that pain worse every time he/she lights one up.
As an orthopedic spine surgeon, I’ve observed this in my own patients who smoke, but the correlation has been well documented. One such study revealed 18 percent greater mean disc degeneration scores in the lumbar (low back) spines of smokers, as compared with nonsmokers.
A recent Association of Academic Physiatrists (AAP) study found that current smokers had more cervical (neck) spine degenerative disc disease as well.
Unfortunately, it doesn’t stop there. Beyond its link to spinal disc degeneration, smoking actually impedes the spine’s overall ability to heal when injured. After an injury, the body’s natural defense is to increase the blood flow and inflammation vital to the healing process. Because smoking reduces blood flow, it also reduces the rate of repair to a spine injury. Smokers tend to have poorer prognoses, require longer recoveries and suffer greater complications after surgery.
When confronted with these facts, spine patients who smoke often want to know if their habit’s effects on the spine are reversible. The answer depends on the onset of disc degeneration and how far it’s progressed. If far enough along, degeneration may cause a disc to collapse and form ossification around the vertebrae—effects that are not reversible in most situations.
That said, the sooner a smoker stops, the greater their chances for recovery, even when degeneration requires surgery. Recognizing the negative impact on outcomes, most surgeons require their patients to stop smoking well before undergoing spine surgery and commit to staying smoke-free throughout their recovery.
In a study focused on smoking and spinal fusion, for example, only 53 percent of non-quitters were able to return to work, in contrast to the 75 percent of patients who quit smoking for more than six months after surgery.
So, to those smokers out there who haven’t already considered quitting for other reasons, consider your spine on smoking.
Hamid Mir, M.D., is a Board Certified Orthopedic Spine Surgeon and the Medical Director of DISC Sports & Spine Center, Newport Beach.
