Smoking and Back Pain
Smoking is a known risk factor for back pain and disc disease. We are increasingly seeing orthopedic surgeons and neurosurgeons refusing to operate on workers' compensation patients with herniated discs if they are smokers. This trend may very well be based on the results of a study presented at the 2013 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). Researchers reviewed smoking cessation rates and related pain in 6,779 patients undergoing treatment for spinal disorders with severe spine or radicular leg pain. Information on each patient's age, gender, weight, smoking history, assessment of pain, treatment type and depression also were assessed.
Overall, 8.9 percent of patients over the age of 55 smoked compared with 23.9 percent of those aged 55 and younger. Twenty-five percent of the patients older than age 55 had quit smoking, as did 26.1 percent of those younger than age 55.
Current smokers in both age groups reported greater pain than those who had never smoked. Average improvement in reported pain over the course of treatment was significantly different in non-smokers and current smokers in both age groups.
Those who quit smoking during the course of care reported greater pain improvement than those who continued to smoke. As a group, those who continued smoking during treatment had no clinically significant improvement in reported pain, regardless of age.
The decision to undergo back surgery is a difficult one. It can be life-changing. Smoking cessation will certainly increase the odds of obtaining pain reduction as well as achieving an excellent recovery, particularly in cases involving lumbar fusions. I have been successful in convincing workers' compensation insurance companies to pay for prescriptions that help with smoking cessation when prescribed by my clients' authorized treating physicians. This has made a huge difference in their lives and in the outcome of their cases.