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Smoking – How Does It Relate To Chiropractic?

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Smokers have up to 20% higher chances of spine surgery failure compared to non-smokers along with post-surgery complications and added costs. Nicotine affects bone formation and repair, hormonal processes, calcium absorption, tendon and ligament healing. It may worsen back pain and rheumatoid arthritis. It increases infections and slows healing of fractures.

When patients seek chiropractic care, the focus is on improving ALL aspects of health, not just the presenting complaint of back or neck pain.

The “Triangle of Health” is represented by an equilateral triangle where each side of the triangle represents one aspect of health. These are structure (something that chiropractic SPECIFICALLY manages), chemical (where we look closely at diet and nutrition), and emotional (which includes anxiety, depression, and/or poor coping strategies). If ANY one side of the triangle gets out of balance, it directly affects the other two sides. The goal is to find balance in this triangle of health.

So, how does smoking fit into this picture? Let’s take a look!

Smoking And Premature Death

Tobacco smoking is currently the largest cause of preventable deaths in the world, as smokers can expect to live seven-to-ten years less and have a three-times greater chance of a premature death than non-smokers, not to mention the poor quality of life with all the comorbid conditions associated with smoking like COPD, emphysema, asthma, heart disease, and many more!

Many body systems are adversely affected by smoking, and the musculoskeletal system is no exception. Most conscientious surgeons will refuse to perform spine surgical fusions on smokers since the failure rate increases significantly (up to 20%) when compared with non-smokers. It has also been reported that smoking is associated with numerous post-surgical complications and associated costs.

There are many reasons why smoking “stinks” including direct toxic effects of nicotine on the cells that make and break down bone, indirect actions on hormones (adrenal and sex hormones especially), problems with calcium absorption, potential reductions in blood vessel oxygen supply, and more!

Smoking And Slow Recovery

Smoking may also hasten the onset or aggravate the progression of rheumatoid arthritis and back pain. What about the muscles and tendons? As chiropractors, we treat MANY sprains and strains of the spine and extremities, and negative side effects from smoking have been found in these types of injuries as well.

For example, in rotator cuff (RC) tendonitis of the shoulder, experts note the following:

  • interference with tendon and ligament healing;
  • open and arthroscopic RC repairs found larger tears in those in heavy smokers and smaller tears in those that smoked less (a dose-dependent relationship).

A longer the history of heavy smoking increases an individual’s risk of developing a rotator cuff tear and the degree of injury (a time-dose relationship).

  • Smokers also had:
  • a 7.5 times higher risk of biceps tendon tears;
  • a greater risk of non-union of fractures and poor union of joint replacements;
  • a reduced blood supply to healing tissues;
  • increased chances for infection due to poor blood supply plus decreased overall immune response and
  • increased bone death (osteonecrosis) risk.

Not only does smoking increase the occurrence of lung cancer, chronic bronchitis, and coronary heart disease, but it also causes many conditions that interfere with longevity, and more importantly, quality of life!

Dr. Blake Kalkstein DC, MS, CCSP, TPI, ART

While earning his D.C. degree, Dr. Blake worked as a chiropractic intern at the Walter Reed National Military Medical Hospital in Bethesda, MD where he had the privilege to work in the amputee rehabilitation center. Dr. Blake’s post graduate sports medicine internship with John’s Hopkins Sports Medicine orthopedic surgeons allowed him to observe all types of injuries. Guidance from Dr. John Wilckens, team orthopedist for the Baltimore Orioles and his internship supervisor, led Dr. Blake to better understand advanced orthopedic and sports injuries and ways to appropriately manage each condition.

Dr. Blake Kalkstein DC, MS, CCSP, TPI, ART

While earning his D.C. degree, Dr. Blake worked as a chiropractic intern at the Walter Reed National Military Medical Hospital in Bethesda, MD where he had the privilege to work in the amputee rehabilitation center. Dr. Blake’s post graduate sports medicine internship with John’s Hopkins Sports Medicine orthopedic surgeons allowed him to observe all types of injuries. Guidance from Dr. John Wilckens, team orthopedist for the Baltimore Orioles and his internship supervisor, led Dr. Blake to better understand advanced orthopedic and sports injuries and ways to appropriately manage each condition.