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Smoking and chronic low-back pain

Chronic low back pain

Smoking and chronic low-back pain

Low back pain has become a global health issue which affects 50% to 80% of people at some time in their life. Low back pain leads to decreased productivity with activities of daily living, reduction in quality of life, and high health care cost. The evidence on the role and mechanism of smoking in relation to low back pain is inconsistent. However, 27 cross-sectional studies have suggested that current smokers as well as those who used to smoke in the past are at greater risk of developing chronic low-back pain when compared to individuals who never smoked. Some studies have shown that smoking is associated with osteoporosis, lumbar disc disorder, and reduced bone healing which subsequently result in chronic pain. Smokers appeared to have more intense pain and more painful areas of body compared to non-smokers as studies suggested. Functional disability and life impairment due to pain is more frequently reported by smokers.

An evidence by Hooten WM and colleagues in 2011, demonstrated that smoking is indirectly associated with measured pain level. According to this study, smoking is directly related to increased level of depression and since depression is significantly associated with increased chronic pain, therefore the indirect link between smoking and pain level can be due to this association.

According to an article published by the National Institute of Neurological Disorders and Stroke in March of 2016, there is a strong correlation between smokers and the presence of the neuropathic symptoms.  Smoking causes the narowing and hardening of blood vessels and decreases blood supply to peripheral nerves with adequate oxygen and nutrition via the vasa nervosum. Smoking would also decrease the ability of body to heal any damaged nerves and increase the healing time of different types of trauma.


1. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The Association between Smoking and Low Back Pain: A Meta-analysis. The American Journal of Medicine. 2010;123(1):87.e7-87.e35.

2.Peripheral Neuropathy Fact Sheet [Internet]. National Institute of Neurological     Disorders and Stroke. 2016 [cited 2 June 2016]. Available from:             http://www.ninds.nih.gov/disorders/peripheralneuropathy/detail_peripher          alneuropathy.htm

Arvin Sepahdoost

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