Monday 28 March 2011

Smoking and DDD

Ex-smoker Michelle Boisvert suffers from degenerative disc disease (DDD). Diagnosed at the age of 33, she has since learned that cigarette smoking is a leading risk factor for degenerative disc disease.

From Michelle:

As someone who is very grateful to have found freedom from nicotine addiction and as someone who suffers from a smoking-related illness, I have been prompted to research and offer my findings about the relationship between smoking and degenerative disc disease.

I was diagnosed with severe DDD in 1998 when I was 33 years old and still a smoker. My orthopedic surgeon discovered the DDD while he was performing surgery after I ruptured a disc in my lower back. Discs are the pliable “cushions” found between the vertebrae, which serve as shock absorbers for the bones in the neck and back.

The term “degenerative disc disease” has met with criticism by some because all discs do degenerate naturally over time. It is a normal part of the aging process, but in some younger adults the discs degenerate more quickly than in others, causing the discs to lose fluid, become less pliable and less able to protect and support the vertebrae. The result can be chronic and debilitating pain.

Although genetic predisposition is the #1 risk factor, a growing number of studies indicate that smoking is a leading risk factor for DDD, both in the lumbar discs (lower back) and cervical discs (neck). Research suggests that smokers have a 3-4 times higher risk of developing DDD and that smoking can exacerbate pre-existing disc degeneration.

Nicotine deprives disc cells of vital nutrients. In addition to nicotine, smokers introduce carbon monoxide into the blood stream and from there into body tissues. These poisons inhibit the discs’ ability to absorb the nutrients they need from the blood. The result can be prematurely dehydrated, less pliable discs – degenerated discs.

As the discs become more and more malnourished, there is a greater risk of a ruptured disc. This occurs when the disc contents break through the outer layer of the disc, often impinging on nerves and causing great pain, numbness, and in some cases nerve damage in the legs or arms. These same poisons also interfere with the absorption of calcium, leading to a compromised vertebral structure.

Coughing, which is more prevalent among smokers, can also add to the risk. Coughing causes increased pressure between discs. This puts added strain on the spine and discs, creating greater risk of disc bulges and ruptures, especially in a spine already weakened because of smoking-related toxins.

Inactivity, which is also frequently associated with the smoker’s lifestyle, can result in a higher frequency of back pain in general, and unfortunately pain associated with DDD can make an active lifestyle more difficult to enjoy.

Treatment for DDD and disc ruptures range from doing nothing to major surgery, including spinal fusion. This surgical procedure involves removing disc material and fusing the vertebrae together with bone grafts and sometimes metal plates, rods and screws.

Anyone who is still smoking by the time this surgery is required is strongly advised to quit smoking prior to surgery. Many surgeons will not perform the surgery until the patient has been smoke-free for several months. Smoking impedes new bone growth, which is instrumental in the success of spinal fusion. Researchers have determined that nicotine is a bone toxin and as a result, the failure rate for many types of fusions can be 3-4 times higher for smokers.

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

To those who might be contemplating quitting and wondering if you have another 10, 20, or 30 years to smoke before you do any real or lasting damage, please think again and don’t take the gamble. It’s so risky, and I urge you to think about what you’re putting on the line. For every warning actually listed on a pack of cigarettes there are many more illnesses, diseases, and complications that smoking can cause. Quit now, and at least know that from this day forward you are doing all you can to protect your health and well-being.

Please take advantage of the wealth of knowledge to be found at the About.com Smoking Cessation web site and check out the Smoking Cessation Forum for the best support on the web.

~Michelle Boisvert~

Sources:


Effect of Nicotine on Spinal Disc Cells. Akmal M, Kesani A, Anand B, Singh A,et al. 1 March, 2004. National Center for Biotechnology Information.

Lumbar Degenerative Disc Disease. Rajeev K Patel, MD. 3 August, 2009. EMedicine.com.

Degenerative Disc Disease and Low Back Pain Thomas G. Lowe, M.D. Spine Universe.

Cigarette Smoking and its Impact on Spinal Fusions. Larry Davidson, M.D. 13 August, 2007.

Spine Surgery and Cigarette Smoking. The Burton Report.

More from Michelle:

]Michelle's Quit Story
Michelle's 1 Year Milestone
Michelle's 2 Year Milestone
Michelle's 3 Year Milestone
Michelle's 4 Year Milestone
Michelle's 5 Year Milestone
Patience With the Process
A Perspective on Using NRT's
There is No Substitute for Time
Managing Quit-Related Depression


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