• Shruti GOCHHWAL

Is Smoking Causing Your Back Pain?

An office worker might attribute his back pain to his uncomfortable chair. A construction worker might blame his jackhammer for back pain. However, if either of them happens to be a smoker, there just might be a contrasting explanation for their back pain.

You probably know that smoking causes lung cancer. But did you know that smoking also causes back pain and other spinal problems?

The same goes for using any nicotine-containing product, like cigars, tobacco, and nicotine gum and patches. Cigarette smoking prevents new bone growth, decreases calcium absorption, and slows down the spine’s healing process.

Coughing because of heavy smoking may also cause increased intra-abdominal pressures which further adds to the back pain.

Let’s look at a few reasons why smoking causes back pain.

Disc Degeneration and Reduced Blood Flow to the Discs

vertebra back pain

Irregularities in the vertebra affects blood flow            Credits: Commons wikimedia


The discs present in the spine are gel-like cushions composed of 70 percent water. The musculoskeletal system needs blood flow, nutrients, oxygen, just like any other organ of the body.

Smoking generates friction between the vertebrae. This affects blood circulation by decreasing the flow of oxygen-rich blood to the back joints and discs.

Nicotine in tobacco causes atherosclerosis, a plaque in the arteries. This narrows the arteries. Narrowed arteries block blood circulation through the body, including disks and joints in the spine.

As a result, the spinal discs become hard, brittle and less elastic leading to disc degeneration. Restricted blood flow further accelerates this process.

When they wear out, these disks herniate or rupture. The soft gel-like core of the disk cracks through the disk’s outer layer. This can put pressure on surrounding nerves, leading to back pain.

When you smoke, you damage your blood vessels, which accelerates the degeneration of your disks, leading to disk herniation and back pain.

The Weakening of Bones, Muscles and Immunity

Nicotine in tobacco triggers the release of dopamine, a chemical which deceives our body into reducing stress and thus feeling good. As a result, smoking becomes addictive.

But the same tobacco decreases the oxygen-rich blood circulation to the tissues and bones, leading to initial signs of degeneration which may further cause impaired bone and wound healing.

Smoking also boosts the risk for osteoporosis, a bone weakening illness that causes back pain and increases the risk of hip and other bone fractures.

Nicotine slows the healing of these bone fractures. This is why patients who require fusion surgery of the spine are asked to stop smoking at least a month before surgery.

Osteoporosis back

Caption: Osteoporosis locations in the back.        Credits: Commons wikimedia     


The failure rate of fusion surgery is twice as big for smokers than non-smokers because of nicotine’s degrading effects on bone growth.

Modified Perception of Pain

Smoking changes the way you perceive pain. Nicotine in tobacco affects the functioning of the brain and increases a person’s reaction to pain.

When the network between the medial prefrontal cortex and nucleus accumbens changes, it makes a person less resilient to back pain.

Nicotine plays an analgesic effect on the cardiovascular system. A study suggests that smoking increases blood pressure, which is linked to reduced pain sensitivity.

A decrease in cardiovascular capacity and fatigue also weakens the muscles, making it difficult for them to support the spine and back.

Why Should You Stop Smoking?

A study by researchers shows that people who smoke are more likely to develop chronic back pain than those who don’t smoke.

The researchers assessed 160 people who had lately developed sub-acute back pain, or back pain lasting 4 to 12 weeks. They also analyzed 32 people with chronic back pain, or back pain for 5 years or more and 35 people with no back pain.

Over one year, participants completed questionnaires to gain information about their smoking habits and other health conditions. They also underwent MRI (magnetic resonance imaging) brain scans.

Researchers say that the brain scans were used to analyze activity between two brain regions, the medial prefrontal cortex and the nucleus accumbens.

steel rod pull-ups

The medial prefrontal cortex and the nucleus accumbens in the brain      Credits: Commons Wikimedia 


Smoking boosts brain activity that decreases resilience to chronic back pain.

The connection between these two brain regions plays an important role in chronic back pain development. The stronger the connection between them, the less resilient a person is to chronic pain.

It was found that compared to non-smoking participants, those who smoked had a stronger connection between the medial prefrontal cortex and the nucleus accumbens.

This increased their risk of chronic back pain. It was also determined that compared to non-smokers, smokers are three times more likely to develop chronic back pain.

There was also a dramatic drop in this region’s activity in smokers who quit smoking. So, when they stopped smoking, their susceptibility to chronic back pain also reduced. This was also attributed to corticostriatal circuitry involved in addictive behaviour towards smoking.

The study concluded that smoking increases the risk of developing back pain.

Quitting smokes is not easy, nevertheless, it is not impossible. You should quit smoking gradually as the body can react adversely should you stop smoking all of a sudden.

One can use nicotine replacement products such as nicotine patches and gum. Seek support from friends and family, exercise more often and be well prepared for the challenges.

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