The Link Between Cigarette Smoking and Degenerative Disc Disease

Smokers With Cervical Degenerative Disc Disease Have Surgery Earlier and More Often

The Link Between Cigarette Smoking and Degenerative Disc Disease

As the global population ages, cervical disc degeneration and myelopathy in the neck of the spine are growing health concerns. While age is a well-known risk factor for degenerative disc disease, new research identified a potential link between smoking (tobacco use disorder), cervical degenerative disc disease and myelopathy.

First: A Quick Lesson on Cervical Degenerative Disc Disease and Myelopathy

What is degenerative disc disease? It’s not really a disease—rather it often starts when age-related or wear and tear injuries alter the structural integrity and strength of one or more intervertebral discs. Discs in the neck or back may bulge, herniate, narrow or flatten and contribute to development of disorders that compress spinal nerve roots and/or the spinal cord. Pain is the hallmark symptom.

When the spinal cord is compressed, the condition is called myelopathy. Some symptoms are attributable to spondylosis, also called spinal osteoarthritis that is arthritis of the spine. Cervical myelopathy is known to cause neurological problems that may affect balance and walking.

Myelopathy from cervical degenerative disc disease can occur when the inner, gel- portion of the disc seeps out from a degenerated disc, which puts pressure on the nearby vertebral body. This can cause osteophytes (bone spurs) to grow, and that can compress the spinal cord. When myelopathy occurs, you may experience nerve-related symptoms numbness, tingling, weakness, and radiating pain.

While degenerative disc disease in your neck alone may be managed with non-surgical treatments, myelopathy requires surgical intervention to relieve spinal cord and nerve compression that may lead to severe symptoms (eg, balance problems, difficulty walking). Decompression surgeries, such as anterior cervical discectomy and fusion (ACDF), posterior cervical fusion (PCF), and anterior cervical corpectomy and fusion (ACCF) are common procedures performed to free up space around the spinal cord.

Closer Look at the Study and Research Findings

Research published in the May 2017 issue of the European Spine Journal looked at patients who had cervical disc degeneration with or without myelopathy between 2007 and 2013.

Using an insurance database to identify the patients, the research team discovered that patients who had been diagnosed with tobacco use disorder (eg, smoking) had spine surgery more often than patients who did not smoke. In fact, smokers were more than twice as ly to undergo cervical spine surgery as non-smokers.

And, it wasn’t just that smokers were having neck surgery more often—they were having the procedure at a younger age. The peak age group for non-smoking patients who underwent surgery was between 60 and 79 years, while the peak age of surgery for smokers was between 40 and 59 years.

“A younger age of onset could result in more lost work time as well as a greater lifetime risk of complications from surgery or the need for revision surgery,” the authors wrote.

The research team also examined whether the smoking patients stopped smoking between the time they were diagnosed with cervical degenerative disc disease and the time of their surgery.

Evidence showed that those who smoked at the time of surgery had a higher risk of complications and infections after surgery—in addition to poorer outcomes.

So patients are recommended to quit smoking at least 4 weeks prior to surgery.

Despite this, the researchers found that the majority of patients who smoked (76.3% who had myelopathy and 68.9% who only had cervical degenerative disc disease) did not quit smoking before surgery.

“This could indicate the need for either more aggressive smoking cessation aid or more restrictive patient selection,” the authors wrote.

How Tobacco Wreaks Havoc on Your Spine

Cigarette smoking is among the top preventable causes of medical problems and death. Tobacco inhibits bone growth and bone health—and certainly includes your spinal bones (vertebrae). Nicotine also reduces your body’s circulation of blood, making it harder for oxygen and key nutrients to move throughout your body.

If you smoke cigarettes (eg, use tobacco) and are exploring the prospect of spine surgery, talk to your spine surgeon about the potential risks you face if you do not quit. He or she may also be able to connect you to resources that can support you if you decide to quit smoking.

You can learn more about how smoking affects your spine—and your ability to successfully recover from surgery—in Cigarette Smoking and Its Impact on Spinal Fusions and Smoking, Tobacco Use, e-Cigarettes and Spine Surgery.

Updated on: 06/26/19


The Link Between Cigarette Smoking and Degenerative Disc Disease

Smoking is a known cause of many long-term, serious health complications, including lung cancer, chronic obstructive pulmonary disorder (COPD), and heart disease. But did you know smoking can also increase your risk for chronic back pain due to herniated discs and degenerative disc disease?

At LA Pain Doctor, experienced interventional pain management physicians, Firas Hijazi, MD, and Satvik Munshi, MD, understand how painful a herniated disc can be. Not only do they offer innovative pain relief options, Dr. Munshi and Dr. Hijazi can also help you improve your spine health through lifestyle modifications and smoking cessation resources.

What a herniated disc means for you

In between the vertebrae of your spine are gel- discs. These discs absorb the shocks of your movements and prevent the bones of your spine from rubbing together.

Owing to your age, smoking history, or due to spine injury, these discs can break down and force the soft center to push through the tough outer layer. This condition is known as a disc herniation and the disc’s bulging center can press on surrounding nerves in your spine.

This pressure on the spinal nerves can lead to persistent back pain and neck pain, numbness and tingling in your arms and legs, and loss of your spine’s range of motion and flexibility.

For some, a herniated disc can cause debilitating pain and interfere with your ability to stay active. If not treated properly in the early stages, a herniated disc may require surgery to remove damaged disc material.

How smoking is linked to herniated discs

Cigarettes contain nicotine, an addictive substance found in tobacco plants. Nicotine acts as both a stimulant and sedative.

When you smoke a cigarette, the nicotine stimulates your adrenal glands to releases a surge of adrenaline. The adrenaline increases your blood pressure, raises your heart rate, and speeds up your breathing activity.

Nicotine can also rob vital nutrients from the cells of your spinal discs that are needed to keep the disc health. Smoking also exposes your body to carbon monoxide, which affects your discs ability to absorb important nutrients from your blood.

Without proper nutrients to sustain it, a disc can dry out and become less flexible. This increases the risk factors for disc herniation during physical activity or because of an injury.

Smoking increases risk for degenerative disc disease

Degenerative disc disease often develops as you get older and age-related changes in your spine cause your discs to break down prematurely.

If you smoke, you may be prone to excessive coughing that puts excess pressure on your discs and strains your overall spine. This pressure can weaken your spinal structures and increase your risk for both a herniated disc and degenerative disc disease.

Treatment options for herniated disc pain

The LA Pain Doctor specialists develop a custom treatment plan to address chronic pain from a herniated disc. They offer nonsurgical solutions, ice and heat therapy, massage, and electrical muscle stimulation to relieve pain and increase mobility in your spine.

Other minimally invasive treatments for herniated disc pain include:

You may also benefit from physical therapy to rebuild the strength of your muscles that support your spine and increase blood circulation that provides nourishment to your spinal joints.

Of course, the best way to avoid damage to your discs caused by smoking is to work through a smoking cessation program that will help you quit for good. The LA Pain Doctor team can recommend resources for quitting smoking and lowering your risk for long-term health complications.

If you have chronic back or neck pain due to a herniated disc, you can learn more about available treatment options by calling the LA Pain Doctor office nearest you or by requesting an appointment online today. 

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