The Link Between Cigarette Smoking and Degenerative Disc Disease

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Updated on November 12, 2021

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Fingers holding a burning cigarette — Cludio Policarpo / EyeEm / Getty Images

Cigarette smoking is an important risk factor for degenerative disc disease (DDD). The term "degenerative disc disease" has been criticized by some because all discs degenerate naturally over time. It's a normal part of the aging process.

However, in some people, the discs degenerate more quickly causing the discs to lose fluid, become less pliable, and become less protective and supportive of the vertebrae. The results can vary with some people experiencing mild symptoms, while others have chronic and debilitating pain.

More research is being done to study the relationship between smoking and DDD, but there is evidence to suggest that quitting smoking now may reduce the risk of developing or exacerbating DDD.

Smoking and Disc Degeneration

Although genetic predisposition is the number one risk factor for DDD, smoking is another, both in the lumbar discs (lower back) and cervical discs (neck).

Research suggests that people who smoke have a greater risk of developing DDD and that smoking can exacerbate a pre-existing disc degeneration.

Nicotine deprives disc cells of vital nutrients. When you smoke, you also introduce carbon monoxide into the bloodstream, which then travels into the body's tissues. The toxins inhibit the discs' ability to absorb the nutrients they need from the blood, including calcium, which leads to a compromised vertebral structure.

This process is what degenerates the discs; they become prematurely dehydrated and less pliable. As the discs become more malnourished, there is a greater risk of a ruptured disc as well, which occurs when the disc's contents, a "jelly-like" substance, spill from its outer layer.

The contents irritate the nerves, which can cause pain, numbness, and in some cases, nerve damage in the legs or arms.

Symptoms of DDD

Some of the symptoms of degenerative disc disease are:

Pain in the neck and/or lower back
Pain that extends to the arms and hands
Pain in the buttocks and thighs
Worsened pain when you stand, lift something, sit, or bend
Weakness in the legs
Foot drop (when you are unable to lift the front part of your foot)

DDD affects everyone differently. People experience varying levels of pain; some people don't have many noticeable symptoms at all.

Other Risks for Disc Damage

There are other smoking-related risks that may lead to disc damage. They include:

Coughing: More prevalent among those who smoke, coughing can also add to the risk of back pain. The abrupt motion that your body makes when you cough consistently increases the pressure between discs. This strains the discs and the spine, creating a greater risk of disc bulges and ruptures (especially in a spine already weakened by smoking-related toxins).
Inactivity: People who smoke, on average, are less physically active than people who don't smoke. Inactivity can result in a higher frequency of back pain in general.

Unfortunately, pain associated with DDD can make an active lifestyle that much more difficult to enjoy.

Mental Health Effects

Degenerative disc disease can take a toll on your mental health as well. Back pain is linked with increased levels of anxiety and depression.

When your body experiences pain, your brain's "pain circuits" are triggered. Over time, the pain triggers the brain circuits that process your emotions as well.

It can become difficult to manage your emotions when you are in chronic pain.

In addition, limited movement that disrupts your daily life is linked with psychological distress. This distress can affect your brain chemistry, limit the production of dopamine (the hormone that releases feelings of pleasure in the body), and in turn, leave you feeling more stressed.

Treatment for DDD

Treatment for DDD varies from lifestyle changes to major surgery. It is important to be evaluated by your doctor in order to determine the treatment approach that is right for you.

Nonsurgical Treatment

A combination of physical therapy and medications can help to relieve the pain associated with degenerative disc disease. Your doctor might recommend any of the following medications, depending on the severity of your pain:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These over-the-counter and prescription medications help with the inflammation that DDD causes. If your pain is severe, your doctor might prescribe you a stronger pain reliever temporarily.
Muscle relaxant: The pain in your spine might lead to muscle spasms; your doctor might prescribe a muscle relaxant for a short time period to alleviate the pain from spasms.
Corticosteroids: These would be prescribed by your doctor and help reduce the inflammation caused by an injured disc.

If you are overweight, your doctor might also recommend weight loss. Excess weight, especially in the front of the body, can pull on the spine and further irritate a spinal injury.

Physical therapy is another common treatment method for spinal injuries. You would learn a series of stretches to relieve tension in the back as well as exercises to strengthen the surrounding muscles such as your abdominals, thighs, and glutes.

Studies show that people who smoke may experience heightened pain sensitivity. Along with receiving treatment, quitting smoking may improve painful symptoms associated with DDD.

Surgical Treatment

Depending on the severity of your condition, and if nonsurgical treatments haven't been effective, your doctor might recommend surgical treatment such as artificial disc replacement or spinal fusion.

An artificial implant might be used to replace a damaged lumbar disk, but this is generally reserved for patients who are functionally disabled by their injury. Spinal fusion, on the other hand, is when a surgeon fuses together the damaged disc with adjacent disks to prevent pain when you move.

It's recommended to quit smoking prior to surgery. Smoking greatly increases the risks of complications from surgery—decreased oxygen levels in the body as a result of cigarette smoke can impair the heart, lungs, and immune system, making it more difficult to recover.

The World Health Organization (WHO) reports that quitting smoking even four weeks prior to surgery can improve the body's ability to recover.

Mental Health Treatment

There are a variety of mental health treatments that can help you cope with pain, relieve the anxiety and stress that contribute to the pain, and even change how you perceive pain. Mindfulness-based stress reduction (MBSR) has been shown to relieve symptoms of anxiety and depression.

One study noted significant improvements in the depressive symptoms of back pain patients after they engaged in MBSR for four weeks.

Cognitive behavioral therapy (CBT) is another treatment type that may be effective. With CBT, a therapist will help you regulate your emotions and find healthy coping mechanisms.

Progressive muscle relaxation (PMR) is another mode of treatment that can help you reduce the harmful effects of psychological stress on your body. PMR is something you can practice on your own. You focus on one part of your body at a time, tense the muscles, and slowly release them. The practice increases awareness of how much tension your muscles are holding and encourages the release of this tension.

A Word From Verywell

If you are concerned about your spinal health, talk to your doctor. They can recommend the best treatment options to address your pain. In addition, your doctor can help you figure out the best way to quit smoking. Many people use a combination of counseling, support groups, and nicotine replacement therapy. Quitting smoking can prevent further damage to your health.

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