Smoking cessation yields better VAS scores for patients with severe back pain

Cessation of smoking in patients with a spinal disorder was significantly associated with less back pain than in patients who continued smoking, according to a recently published study.

“We know that nicotine increases pain. In this study, if you quit smoking during treatment, you got better,” Glenn R. Rechtine, MD, from the University of Rochester Department of Orthopaedics, stated in a press release. “If you continued to smoke, there was statistically no improvement, regardless of the treatment you had. Basically, the likelihood to improve your care – surgical or non-surgical – was dramatically decreased if you are a smoker.”

Rechtine and colleagues found that of 5,333 patients with axial or radicular pain, patients who never smoked or ceased smoking during the study period reported significantly better VAS scores compared to patients who continued smoking, according to the abstract. Oswestry Disability Index scores in non-smokers also showed a greater mean improvement than in smokers, the researchers noted.

The study measured VAS pain during three different time periods – worst, current and weekly pain levels – and current smokers reported significantly greater pain than all other groups in the three areas, according to the abstract.

“This study supports the need for smoking cessation programs for patients with a painful spinal disorder given a strong association between improved patient reported pain and smoking cessation,” Rechtine said.


Behrend C. J Bone Joint Surg. 2012;doi: 10.2106/JBJS.K.01598.

Disclosure: Rechtine’s institution received a grant from Southwestern Foundation for his work on this study.