Smoking and Chronic Pain
If you smoke you don’t need anyone to tell you that there are potential health problems that are likely to arise as a result – sooner or later. Did you know though that smoking can have a detrimental effect on recovery from back pain?
Dr. Tim Taylor is a chronic pain specialist. He writes“Smoking was established long ago as a strong predictor of failure of pain treatment.” He went on to say “Smokers are so difficult to treat that I will not accept smokers as patients. That is a powerful statement.
Smoking is now considered a major risk factor for chronic pain. Chronic or long lasting back pain is a complex issue and we should not put down all pain to our ‘Degenerating spines’ or our ‘Crooked back’ or the “Sporting injuries’ we have suffered.
Ironically, nicotine is also a pain-killer — but that short term effect is overwhelmed by the long term impact on pain.
Studies strengthen the link between smoking and lower back pain, and also shed light on the causes of degenerative lumbar spine problems.
The study on smoking and low back pain, which prospectively examined 1,337 physicians who graduated from Johns Hopkins University between 1948 and 1964, followed some participants for more than 50 years.
Researchers discovered that smoking history, hypertension (high blood pressure) and coronary artery disease – all of which are risk factors for atherosclerosis, or occlusion of the arteries – were significantly associated with the development of low back pain.
These same risk factors, along with abnormally high blood cholesterol levels, were also significantly associated with the development of lumbar spondylosis. The findings provide support for the hypothesis that atherosclerosis causes lower back pain and degenerative disorders of the intervertebral discs.
Smoking and Low Back Pain Study Results
The study results, which were reported at the 2001 annual meeting of the American Association of Orthopaedic Surgeons in San Francisco, helps support the theory that the mechanism of injury in low back pain is damage to the vascular structures of the discs and joints. If insufficient blood flow arrives at the discs of the low back then those discs degenerate.
Numerous researchers have proposed a link between smoking and low back pain, but the exact nature of that link had remained largely untested in terms of long-term prospective studies. “Because we had the subjects’ medical records and answers from self-reported questionnaires over such a long period of time, a 53-year period of time for the oldest patients, we were able to determine if the risk factors, such as smoking or high cholesterol, preceded the development of the disease years later,” said Nicholas U. Ahn, Chief Resident in the Department of Orthopedic Surgery at the Johns Hopkins Hospital in Baltimore and co-author of the study.
“To prove a causative association from a long-term prospective study is very powerful because one can show that the cause occurred before the effect as opposed to the other way around,” Dr. Ahn explained.
Conclusions from Smoking and Low Back Pain Study
The study concluded that development of lower back pain was significantly associated with smoking history and hypertension, and development of lumbar spondylosis and stenosis was significantly associated with smoking history, and hypertension and high cholesterol.
Light at the end of the tunnel!
There is some good news however, research looked at six articles on 70 patients who had chronic low back pain due to degeneration of the lumbar spine, and the conclusion was reached that chiropractic care is potentially beneficial in the treatment of patients with lumbar spinal stenosis. Therefore as well as obviously suggesting you give up smoking, we suggest you try a few chiropractic treatments – if they help then you will feel a lot better. If however after a few treatments you feel no benefit, treatment will cease and at least you know you have tried.