Study finds putting out cigarettes won't put out patient backs

Smoking can be a pain in the back. Literally.

Research conducted over the years has identified time and again a linkage between smoking and an influx in low back pain, intervertebral disc disease and inferior patient outcomes. And the latest study, hailing from the University of Rochester, finds no different.

According to the report, published in the December edition of the Journal of Bone and Joint Surgery, smokers were far more likely to suffer from spinal disorders and lower back pain as a result of spinal complications than their quitting, non-puffing counterparts. Over the course of eight months, researchers monitored the axial and radicular pangs of 5,300 patients who had a history of spinal disorders, either surgically treated or otherwise.  

The results came back as such: “At the time of entry into care, patients who had never smoked and prior smokers reported significantly less back pain than current smokers and those who had quit smoking during the study period. Current smokers reported significantly greater pain in all visual analog scale (VAS) pain ratings  worst, current and average weekly pain  when compared with patients who had never smoked.”

Other key findings included:

  • Those who quit smoking during the course of care reported greater improvement in reported back pain than those who continued to smoke.
  • The mean improvement in VAS pain ratings was clinically significant in nonsmokers.
  • The group that continued smoking during treatment had no clinically significant improvement in reported pain.
  • Using the Oswestry Disability Index (the most commonly used outcome measure for low back pain assessment), greater mean improvement was observed in patients who had never smoked when compared to current smokers.

"We know that nicotine increases pain," said study author Glenn R. Rechtine, MD, University of Rochester Department of Orthopaedics, in a news release. "In this study, if you quit smoking during treatment, you got better. If you continued to smoke, there was statistically no improvement, regardless of the treatment you had. Smoking is bad for you. Basically, the likelihood to improve your care  surgical or non-surgical — was dramatically decreased if you are a smoker.”

If anything, Rechtine and the study cohort hope their additional research will move policymakers and other community movers and shakers to vie for more cessation programs.

"This study supports the need for smoking cessation programs for patients with a painful spinal disorder given a strong association between improved patient reported pain and smoking cessation," he concluded.