Date of Award


Document Type

Scholarly Project

Degree Name

Master of Physical Therapy (MPT)


Physical Therapy

First Advisor

Henry C. Wessman


Low Back Pain; Smoking


The purpose of this independent study is to define presently existing theories linking cigarette smoking and low back pain. It also provides a detailed description of nicotine and its physiological and psychological effects.

There are four theories outlined in this study which could serve as explanations for the correlation of cigarette smoking and low back pain. The first is the chronic cough associated with smoking. This cough increases mechanical stress including higher disc pressures and poor union and healing following spinal fusion surgery. The second theory deals with the vascular changes caused by nicotine which decreases vertebral blood flow and solute transport. Thirdly, smoking accelerates osteoporosis. The last theory links cigarette smoking and low back pain with similar psychological and physiological traits.

There is enough evidence to show a strong correlation between cigarette smoking and low back pain, however no conclusive evidence exists to demonstrate cigarette smoking as a causative factor of low back pain. The information is strong enough to alert the healthcare provider to not overlook cigarette smoking when treating a patient with low back pain.