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How Does Being a Smoker Affect Your Back?


Updated February 10, 2012

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: How Does Being a Smoker Affect Your Back?
If you are a smoker, most likely someone, at some time, has warned you about the health risks associated with your behavior. Heart disease, cancer and other serious illnesses top the list. But did you know that back pain is on there as well? Here are the smoking statistics as they relate to spine pain.

Studies show that smoking is at least modestly associated with back pain. For example, a Finnish review of 40 studies examined the relationship between smoking and back pain in the January 2010 issue of American Journal of Medicine. The review found significantly more low-back pain in study participants who smoked than in the non-smokers. Specifically, the analysis found current smokers to be 1.16 times more likely to have had low-back pain in the past month and 1.26 times more likely in the past year.

Does Smoking Cause Spine Problems?

This association does not mean that smoking causes back pain. But it does suggest that smoking plays a role in disc degeneration and other back ailments.

While genetics are probably the biggest cause of spinal degeneration, low-back and neck arthritis are at least three times more common in smokers, said Dr. Eeric Truumees, orthopedic surgeon, Seton Spine and Scoliosis Center in Austin, TX. Dr. Truumees said that problems stemming from spinal degeneration include arthritis of the neck and back, herniated discs and bone spur formation (spinal stenosis).

Smoking increases the rate at which discs degenerate, according to Dr. Alexander Vaccaro, attending surgeon, orthopedics and neurosurgery, Thomas Jefferson University Hospital in Philadelphia.

Teens and Women Smokers Are at Increased Risk for Back Pain

Women smokers seem to be at increased risk for back pain, even if they are only light smokers, said Dr. Truumees. The Finnish review mentioned above noted that the association between low-back pain and teens was stronger than for adults. In that review, teens who were current smokers were 1.82 times more likely to experience low-back pain than adult smokers.

Silver Lining in the Cloud

The good news is that the effects of smoking on the spine are in part reversible. That is, when you quit smoking, you may find you have less back pain, too. While the Finnish review noted more back pain in people who had successfully quit smoking than in those who had never smoked, former smokers had less back pain than current smokers.


Shiri et al. The association between smoking and low back pain: a meta-analysis. AmJ Med. 2010 Jan;123(1):87.e7-35. http://www.ncbi.nlm.nih.gov/pubmed/20102998

Email Interview. Solomon, Jennifer MD. Hospital for Special Surgery. New York. Jan 2012.

Email Interview. Truumees,E. MD. Seton Spine and Scoliosis Center. Austin, TX. Feb. 2012.

Vaccaro, A. Spine: Core Knowledge in Orthopaedics. Elsevier Mosby.205. Philadelphia.

Vestergaard P, Mosekilde L. Fracture risk associated with smoking: a meta-analysis. J Intern Med. 2003 Dec;254(6):572-83. http://www.ncbi.nlm.nih.gov/pubmed/14641798

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