Ask the Doctor

Answered by Dr. Thomas J. Dowling, Senior Partner.

Q: Does smoking really affect my back?

A: Everyone is aware of the negative impact that smoking has on our general health including our heart and lungs.  We all know how smoking decreases our sense of taste and smell, as well as, how smokers tend to look older than their age.  This is because substances within cigarette smoke affect connective tissue.  What one may not be aware of is that this connective tissue not only involves the skin, but also our muscle and skeletal structure.  The spine is particularly prone to damage.  Degenrative or age-related changes are noted on x-rays.  What we do know is that when someone smokes, the acceleration of these degenerative changes is 4 times that of a non-smoker’s pace.  When things degenerate or “wear out” they are more apt to fail, ie., rupture or herniate.  Smokers tend to have a much higher rate of disc degeneration and as a result, double the risk for disc herniations.

When one looks at smokers, there is a higher incidence of back pain as compared to nonsmokers, and when a smoker requires surgical intervention, there is an increased risk for complications and failure of their surgery due to a number of factors.  These factors include an increased risk of: infection, blood clots and lung or pulmonary complications including pneumonia.  There is an increased risk for faikure of any spine surgery, especially those involving bone healing or fusions.  Smoking is not benign.

If you are living constantly with back pain, one of the most substantial things you can do to help your back, is to stop smoking.  If you are a smoker and surgery is ever indicated, if you stop smoking six weeks prior to the surgical date, your risk of complication drops down to the same as a nonsmoker.  For a healthy back, one has to treat their body accordingly in terms of good nutrition, good sleep patterns, and regular exercise routines.  Healthy habits are essential.  Smoking tends to negate any benefits that you may have created with any other lifestyle change.