Got Chronic Neck Pain? Stop Smoking Now!

Smoking may worsen cervical spine degeneration

(RxWiki News) It’s a well-known fact — cigarettes are bad for your health. Just how far the negative health effects of cigarettes reach, however, may come as a surprise to many.

A new study from Emory University has linked smoking cigarettes with degenerative disc disease in the cervical spine, a condition which can cause chronic neck pain.

The cervical spine is located in the neck and is comprised of vertebrae, as well as cervical discs, which sit between the vertebrae and absorb shock to the spine. As people get older, these discs dehydrate and shrink, which can cause chronic pain to develop.

"Smoking is not healthy for a person’s intervertebral discs given the risk of developing microvascular disease — a disease of the small blood vessels — due to nicotine abuse," said lead investigator Mitchel Leavitt, MD, in a press release. Dr. Leavitt is a resident doctor in Emory’s Department of Physical Medicine and Rehabilitation.

Intervertebral discs get their nourishment from the microvasculature system, a small system of blood vessels that line either side of the discs. Nicotine can damage these blood vessels, causing the discs to receive improper nourishment and degenerate faster.

Although past research has linked smoking to disc degeneration in the lumbar spine (near the base of the spine), none have linked smoking with degeneration in the cervical spine.

This study looked at the CT scans of 182 patients who were scanned for various reasons, more than half of whom were women and 34 percent of whom were smokers. Researchers asked a radiologist with training in neuroradiology and a physiatrist to review these scans.

Each disc was rated on a scale between 0 and 3 (as normal, mild, moderate or severe) depending on how much it had degenerated. A cumulative score between 0 and 15 was then given for the entire cervical spine.

Dr. Leavitt and team also looked at how often patients smoked and for how long, and then adjusted for health factors such as age, body mass index, high blood pressure, high cholesterol and diabetes.

On average, current smokers were more likely to have cervical degenerative disc disease. Age made the disease worse, but coexisting conditions like diabetes, high blood pressure, high cholesterol and high BMI did not.

"This is another example of the detrimental effects of smoking," Dr. Leavitt said. "Pain and spine clinics are filled with patients who suffer chronic neck and back pain, and this study provides the physician with more ammunition to use when educating them about their need to quit smoking."

The study was presented Feb. 18 at the Association of Academic Physiatrists' Annual Meeting in Sacramento, CA. Research presented at conferences may not have been peer-reviewed.

Information on funding sources and conflicts of interest was not available at the time of publication.

Review Date: 
February 19, 2016