Smoking can increase the risk of lower back pain that requires spinal surgery, according to a study published in The Spine Journal.
Researchers looked at cases of lumbar spinal stenosis — a common cause of lower back pain that develops when the spinal canal narrows, putting pressure on the spinal cord and nerves. Although the condition can develop as people age, nicotine can contribute to the process by constricting blood flow and increasing inflammation.
The study team gathered data on 331,941 construction workers who were on a nationwide occupational health registry in Sweden. The study followed workers for more than three decades on average, beginning when workers were usually in their 30s. In the study, 1,623 participants eventually had surgery for lumbar spinal stenosis.
Here are five findings from the study.
1. In all, 44 percent of participants were non-smokers. Another 16 percent were former smokers, while 26 percent were moderate smokers and 14 percent were heavy smokers.
2. Heavy smokers who smoked at least 15 cigarettes a day were 46 percent more likely to have surgery for lumbar spinal stenosis when compared to participants who never smoked. The connection between smoking and spinal surgery persisted after researchers accounted for aging and obesity.
3. The increased risk for lumbar spinal stenosis surgery was 31 percent for moderate smokers who had up to 14 cigarettes a day. Ex-smokers saw a 13 percent increased chance for surgery.
4. Although previous research has linked smoking to worse outcomes from spinal surgery, this study offers additional evidence that smoking can also increase the chances that back pain will require surgery, said Arkan Sayed-Noor, MD, PhD, senior study author.
5. The authors noted the study was limited by a lack of data on exercise habits and that most of the construction workers in the study were men. The results may have differed for women.