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Can Smoking Cause Back Pain?

Recently, as I was sitting in my barber's chair receiving my bi-monthly trim, he stopped to ask me a question. With a tinge of disbelief in his voice, he asked me if it was possible if his chain smoking habit could be contributing to the back pain he had been experiencing. He seemed genuinely aggravated at the idea. To his chagrin, I proceeded to tell him about the effects of smoking on the spine and how, yes, that can manifest itself as back pain.

The owner of the store next door (let's call him Bill), a longtime smoker who suffered from back pain himself, was also in the barber shop and couldn't help but overhear us. He aggressively chimed in with his opinions on the subject, but he also listened with a fair amount of intrigue. It was a great back and forth, colorful to say the least, as one would expect from a barbershop in the middle of Calle Ocho. Near the end of it, Bill said that if quitting smoking could really help his back pain, he would drop it cold turkey. I then, of course, challenged him to do so until we saw each other next. Honestly, I never thought he would be able to do it. It wasn’t because I thought Bill wasn't strong enough, but only because he wouldn't have been the first person I've encouraged to quit smoking who hadn't. I just assumed he would succumb to his cigarette cravings, like many other smokers I’d met in the past had. To my great surprise, when I ran into Bill about a month later, he told me that ever since that day we first spoke, he had successfully quit smoking! That alone made me smile, but the next bit of news made my grin double in size. He told me his back pain was almost entirely gone. The smile on his face was as big as mine.

The reality is that back pain is complicated; there is no one thing that will cure it. Smoking is simply one factor among many that can contribute to what is now one of the most costly conditions in the USA. However, don't take my word or even Bill's experience for it. Here is some research I've been reading on the subject:

- In one study of 95,000 nurses, women who smoked were three times more likely to develop psoriatic arthritis. This inflammatory arthritis causes pain in the low back and sacrum. Past smokers were 1.5 times more likely to develop psoriatic arthritis, and women who smoked for over 25 years had the highest risk of all. Researchers suggested that smokers may be more susceptible to psoriatic arthritis because smoking could induce oxidative stress that causes inflammation and harms the immune system.

- In another new study, smokers were more likely to have an early onset of inflammatory back pain. Compared to non-smokers, patients who smoked had greater disease activity, worse function, and a poorer quality of life. MRI scans revealed that smokers were also more likely to have structural lesions on their spines and sacroiliac joints. More severe symptoms forced smokers to miss work more often than nonsmokers. Researchers recommended that patients with inflammatory back pain be “strongly advised” to quit smoking.

- Previous research has shown that smoking can increase your risk of developing sciatica and other chronic pain conditions. If you suffer from back pain, a doctor of chiropractic can ease your pain while supporting you in making healthy lifestyle choices to reduce pain and improve your overall health.


Chung HY, Machado P, Heijde D, et al. Smokers in early axial spondyloarthritis have earlier disease onset, more disease activity, inflammation and damage, and poorer function and health-related quality of life: results from the DESIR cohort. Annals of the Rheumatic Diseases 2012;71:809-816. doi:10.1136/annrheumdis-2011-200180.

Li W, Han J, Qureshi A. Smoking and risk of incident psoriatic arthritis in US women. Annals of the Rheumatic Diseases 2012;71:804-808. doi 10.1136/annrheumdis-2011-200416.

Walsh, Nancy. Smoking Tied to Back Pain, Arthritis. Medpage Today. May 18,2012. Accessed May 24, 2012.

#smoking #hormones #contamination #fishoil #herniateddisc #posture #supplements

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