Does smoking cause low back pain? (Research article)
Recent study on smoking and low back pain offers
new insights
A new study strengthens the link between smoking
and lower back pain, and also sheds light on the causes
of degenerative lumbar spine problems.
The study on smoking and low back pain, which prospectively
examined 1,337 physicians who graduated from Johns
Hopkins University between 1948 and 1964, followed
some participants for more than 50 years. Researchers
discovered that smoking history, hypertension and coronary
artery disease—all of which are risk factors
for atherosclerosis, or occlusion of the arteries—were
significantly associated with the development of low
back pain.
These same risk factors, along with abnormally high
blood cholesterol levels, were also significantly associated
with the development of lumbar spondylosis. The findings
provide support for the hypothesis that atherosclerosis
causes lower back pain and degenerative disorders of
the intervertebral discs.
Smoking and low back pain study results
The study results, which were reported at the 2001
annual meeting of the American Association of Orthopaedic
Surgeons in San Francisco, lend support to the theory
that the mechanism of injury in low back pain is damage
to the vascular structures of the discs and joints.
Numerous researchers have proposed a link between
smoking and low back pain, but the exact nature of
that link had remained largely untested in terms of
long-term prospective studies. "Because we had
the subjects' medical records and answers from self-reported
questionnaires over such a long period of time, a 53-year
period of time for the oldest patients, we were able
to determine if the risk factors, such as smoking or
high cholesterol, preceded the development of the disease
years later," said Nicholas U. Ahn, Chief Resident
in the Department of Orthopedic Surgery at the Johns
Hopkins Hospital in Baltimore and co-author of the
study.
"To prove a causative association from a long-term
prospective study is very powerful because one can
show that the cause occurred before the effect as opposed
to the other way around," Dr. Ahn explained.
Conclusions from smoking and low back pain study
The study concluded that development of lower back
pain was significantly associated with smoking history
and hypertension, and development of lumbar spondylosis
was significantly associated with smoking history,
and hypertension and high cholesterol. No significant
association was reported between diabetes and lower
back pain or lumbar spondylosis.
By: Donald J. Frisco,
MD
July 31, 2001
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