The Impact of Smoking on Low Back Pain and Disability

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-05-20 DOI:10.1002/ejp.70041

Lukas Schönnagel, Bernhard U. Hoehl, Nima Taheri, Luis Becker, Phillip Suwalski, Friederike Schömig, Paul Köhli, Hendrik Schmidt, Matthias Pumberger

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引用次数: 0

Abstract

Background

Low back pain (LBP) is a predominant cause of disability, imposing a significant burden on healthcare systems and individuals' quality of life. The multifactorial nature of LBP encompasses various risk factors, but the association between smoking and LBP, particularly concerning severity and disability, has not been fully explored.

Methods

This study utilised a cross-sectional design with propensity score matching to analyse the relationship between smoking and LBP severity and associated disability among adults aged 18 to 64. We prospectively recruited individuals from the general public, assessing LBP severity and disability using the von Korff questionnaire and the Roland Morris Disability Scale (RMDS). Smoking status was classified as ‘yes’ or ‘no’ and further stratified by pack years (PY). Adjustments were made for age, sex, body mass index (BMI), alcohol consumption, physical activity, and depression.

Results

A total of 430 patients with a median age of 41 (IQR 31–53) were included in the analysis, with 79 (18.4%) being active smokers. In the propensity score-matched analysis, individuals with 0 to < 10 PY did not show a significant increase in pain-related outcomes, whereas those with ≥ 10 PY exhibited a significant increase in pain severity (p = 0.043), disability score (p = 0.001), and RMDS score (p = 0.015). Multivariable linear regression further confirmed a significant association between PY and LBP-related outcomes, whereas smoking status alone was not significant.

Conclusions

This study shows an independent effect of smoking on disability and pain severity, underscoring the potential importance of smoking cessation in LBP management.

Significance Statement

This study identified a dose–response relationship between smoking and increased low back pain (LBP) severity and disability, particularly among individuals with ≥ 10 pack years, strengthened by the robust propensity score-matched design. By highlighting the independent effect of smoking on pain and disability, these findings emphasise the role of Smoking in the development of LBP and the potential importance of smoking cessation as a critical component in managing LBP.

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吸烟对腰痛和残疾的影响

背景：腰痛（LBP）是致残的主要原因，对医疗保健系统和个人生活质量造成了重大负担。腰痛的多因素性质包括各种危险因素，但吸烟与腰痛之间的关系，特别是在严重程度和残疾方面，尚未得到充分探讨。方法本研究采用倾向评分匹配的横断面设计，分析18 - 64岁成年人吸烟与腰痛严重程度及相关残疾的关系。我们前瞻性地从公众中招募个体，使用von Korff问卷和Roland Morris残疾量表（RMDS）评估LBP严重程度和残疾程度。吸烟状况分为“是”或“否”，并进一步按包年（PY）分层。对年龄、性别、身体质量指数（BMI）、饮酒、体育活动和抑郁症进行了调整。结果共纳入430例患者，中位年龄41岁（IQR 31-53），其中79例（18.4%）为活跃吸烟者。在倾向评分匹配分析中，0至10 PY的个体疼痛相关结果没有显著增加，而≥10 PY的个体疼痛严重程度（p = 0.043）、残疾评分（p = 0.001）和RMDS评分（p = 0.015）显著增加。多变量线性回归进一步证实了PY和lbp相关结果之间的显著关联，而吸烟状况本身并不显著。本研究显示吸烟对残疾和疼痛严重程度的独立影响，强调了戒烟在腰痛治疗中的潜在重要性。本研究确定了吸烟与腰痛（LBP）严重程度和残疾增加之间的剂量反应关系，特别是在≥10包年的个体中，通过强大的倾向评分匹配设计加强了这一关系。通过强调吸烟对疼痛和残疾的独立影响，这些研究结果强调了吸烟在腰痛发展中的作用，以及戒烟作为治疗腰痛的关键组成部分的潜在重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.