Smoking and Low Back Pain
SOURCE: Shiri R, Falah-Hassani K. The effect of smoking on the risk of sciatica: A meta-analysis. Am J Med 2016;129:64-73.
Low back pain and its consequences are responsible for the largest single expenditure of disability dollars in the United States. Whereas both the clinician and lay population have a high level of awareness of the consequences of smoking, such as heart disease, lung disease, and various cancers, the relationship between smoking and sciatica is not widely recognized. Of course, when an individual patient encounters a potential or real consequence of smoking (e.g., abnormal chest CT, pneumonia, etc.), he or she sometimes becomes — at least transiently — more motivated to quit. There are even data showing that among otherwise healthy young men who fracture their tibia, healing occurs weeks earlier in non-smokers, providing clinicians a teachable moment when they encounter such a patient. Might we add low back pain to that list?
Shiri and Falah-Hassani reviewed data from 28 studies (n = 20,111) in which sciatica risk was compared between smokers and non-smokers. Overall, current smokers were more than 60% more likely to experience any radicular back pain, and 35% more likely to incur sciatica. Similarly, the odds ratio for back pain-related hospitalization or surgery was elevated to 1.45; encouragingly, former smokers demonstrated only slight risk elevation.
This is the latest in a long list of reasons to encourage smoking cessation.
Yet another reason to encourage smoking cessation.
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