Nicotine harms bones, muscles, and joints - Smoking - medical research - Brief Article

USA Today (Society for the Advancement of Education), Oct, 2002

Cigarette smoking is not only bad for your heart and lungs. New reports are showing nicotine is bad for your bones, muscles, and joints as well. According to Edwin J. Hanley, chairman, Department of Orthopaedic Surgery, Carolinas Medical Center, Charlotte, N.C., "Nicotine slows fracture healing, estrogen effectiveness, and it counteracts the antioxidant properties of vitamins C and E, predisposing smokers to increased hip fracture risk." In addition, lower back pain and sciatica are more common in smokers, especially those who have smokers' cough. This possibly is due to increased intradiscal pressure, he suggests.

"Cigarette smoking is implicated in several musculoskeletal disease processes, including osteoporosis, low back pain, spinal disc disease, and wound healing," Hanley notes. "Smoking increases the incidence of spinal compression fractures in postmenopausal women because they have less bone mass." In addition, studies show that:

* Cigarette smokers have more-severe disc degeneration than nonsmokers.

* Smoking weakens spinal ligaments and reduces the production of bone cells.

* Postmenopausal women who smoke lose bone faster than their peers.

* Rotator cuff (shoulder) surgery is more successful for nonsmokers than smokers.

* Smokers have more complications after surgery.

* Surgical incisions take longer to heal, probably because the tissues are not getting sufficient oxygen.

* Bone regeneration improves if the patient stops smoking.

* Spinal fusion is delayed by nicotine in a person's system.

A study by Hanley found that back pain from a work-related injury was more common among employees who smoked. "Fifty percent of the workers who smoked had low back pain, compared to 20% of the nonsmokers. The study also showed that workers who smoked had disabling leg cramps, and severe back pain," He cautions that anyone having elective surgery should stop smoking at least two weeks before the procedure. A nicotine patch should not be used before surgery either.