How Does Smoking Affect Back Pain?

February 11, 2022
By Justin Field, M.D.
Dr. Field is a board certified, fellowship trained orthopedic spine surgeon. Dr. Field has specialized training in minimally invasive spine surgery and motion sparing technologies, such as cervical and lumbar Artificial Disc Replacement, as well as non-fusion stabilization. In addition, he has extensive training in adult deformity correction and treatment.


Smoking is linked to numerous chronic pain symptoms and diseases. As of 2014, over 16 million Americans were living with a smoking-related illness. Many people who smoke cigarettes or use vaping devices also report a common symptom — back pain. This commonality has led many researchers to study the relationship between smoking or vaping and back pain.

People who experience back pain from smoking may also have undetected spinal conditions. This chronic pain may indicate degenerating cells or worsening bone health, both of which can irrevocably harm your body. However, if patients decrease their nicotine intake early enough, they could see and feel the difference of a healthier spine.

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The Link Between Smoking and Chronic Pain

Smoking cigarettes regularly ensures a consistent flow of nicotine to your brain. People who smoke inhale about 1-2 milligrams of nicotine per cigarette, equaling up to 20-40 milligrams per pack. Inhaling tobacco also releases tar and carbon monoxide into your lungs, both toxic substances that can affect your overall health in many ways.

Many researchers have found a link between smoking and chronic pain. Because cigarettes and tobacco products are filled with toxic inhalants, smoking creates many health conditions that result in persistent pain. Smoking-related diseases are certainly not limited to back pain, as cigarette ingredients can have many effects on the human body.

The scientific explanation for smoking and chronic pain comes down to your cells. Nicotine and tobacco can deprive your cells of their necessary functions, which weakens their ability to perform throughout your body. Your diminished cells can create chronic conditions such as rheumatoid arthritis, degenerative disc disease and oral pain.

Some researchers find that smoking and pain exist in a “positive feedback loop.” Some people use their chronic pain as a motivator to smoke, while smoking can also cause chronic pain conditions. This deadly cycle traps millions of Americans every day and can cause far more pain in the long run than it solves.

Can Smoking Cause Back Pain?

Current smokers may report symptoms of lower back pain that seem unrelated to their smoking habits. However, a 2000 study review found a positive association between active smoking and back pain. Out of 46 studies, 36 found that both men and women had experienced back pain from smoking. Additionally, a 2016 study found that smoking is a risk factor for lumbar pain and sciatica.

So, does smoking cause back pain? It definitely increases the risk of back pain and spinal disc degeneration. Toxic substances, like the carbon monoxide from tobacco, can damage spinal disc cells and blood vessels’ interior lining. Nicotine can shrink blood vessels, which restricts the flow of crucial nutrients like calcium.

Over time, cells degenerate or die, which impacts spinal cushions and breaks down the vertebral discs. This process can lead to degenerative disc disease (DDD), which often causes lower back pain or stiffness in your spine. Overall, smoking cigarettes causes cell malnutrition, wreaking havoc on your spinal cushions and vertebrae.

Effects of Smoking on Spine Health

Some people who smoke will not experience a direct connection between smoking or vaping and lower back pain like DDD. However, smoking-related diseases can be tied to several spinal conditions that create a similar effect.

Smoking is a well-known risk factor for osteoporosis, a disease that weakens your bones over time. This decreased bone density can lead to chronic back pain or spinal fractures. Smokers with developing osteoporosis are more likely to experience a life-changing vertebral compression fracture. This injury happens when weakened vertebrae induce a spinal collapse. A vertebral compression fracture can create chronic pain, lead to a disability or limit your mobility.

Aside from the effects of osteoporosis, smoking and vaping can reduce your physical activity and create other forms of chronic back pain. Researchers have found that smoking and physical activity have an inverse relationship, which means that people who smoke are less likely to be active adults. Because regular exercise improves bone density, smoking could negatively affect a person’s spinal health both physically and behaviorally.


  • Pain throughout the torso or lower back
  • Weakness in the legs
  • Pain when sitting, bending over or lifting items
  • Feelings of distress, anxiety or depression

How Smoking Affects the Back’s Ability to Heal

Some active smokers will recognize intense lower back pain and assume the damage has been done. Fortunately, you can alleviate your back pain and mitigate the risks of further spinal degeneration. The best way to begin healing is to stop or significantly reduce smoking.

Recovering from chronic back pain may involve any range of physical therapies, surgeries or habit changes. Quitting smoking and vaping is one of the best things you can do for your body. Researchers have found that smoking cessation can improve spine health and reduce the risk of diseases like sciatica. You may see excellent progress without surgery when you quit smoking.

Your chronic pain recovery begins when you get rid of the toxic substance that has weakened your body over time. Studies have found that smoking can increase your pain sensitivity, meaning your chronic back pain may feel worse because you smoke. In turn, you may feel less pain once you quit smoking and speak with a specialist about your lower back pain.

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Smoking and chronic pain have what some researchers call a comorbid relationship. Pain can lead people to begin smoking and may be similar to what they feel later in life because of smoking. This cycle can cause irreversible damage to your spine.

Chronic back pain is a prevalent condition that affects millions of adults. Its worst cases can prevent you from enjoying many simple pleasures of life. At Desert Institute for Spine Care, we treat hundreds of patients with chronic back pain. Our personalized diagnostic approach finds the source of your pain and helps you address solutions or appropriate treatment.

If you smoke and have noticed symptoms of chronic back pain, our specialists can help you identify solutions. We begin with the root and create an individualized plan to help you feel better. We start with minimally-invasive treatments, such as medication or therapeutic injections, but can also perform innovative surgical procedures.

DISC specialists are Arizona’s leaders in minimally invasive spine care. Our procedures range from traditional treatments to complex spine surgery. We will always recommend the least invasive option to alleviate your pain. If you want to know more about our services, you can contact us online. Call 602-944-2900 if you have questions.

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