Smoking: Bad for the Bones, Too – By William P. Rix, MD

Posted on September 17, 2012 by NHOC Tech under Dr. Rix, Featured Articles

It is well known that smoking is bad for the heart and lungs, but did you know it’s very harmful to the bones and their soft tissues? The ingredients in cigarette smoke impair the body’s ability to deliver oxygen, immune cells, and bone and soft tissue repair cells to fractures and surgical wounds.

Smokers have 6 times the rate of post-operative infections as nonsmokers, 4 times as many fracture nonunions and a wound complication rate after total joint surgery that approaches 50%. Large studies of patients with low back pain have shown that smokers have more pain and more disability than their nonsmoking counterparts. Smoking is also linked to thinning of the bones (osteoporosis) and fragility fractures (bones that break after minor trauma).

As alarming as these reports are, there is some good news. Smokers who quit as little as 4 weeks prior to their surgery can reduce their post-operative complication rate by more than half. Going from smoking to nonsmoking improves fracture union rate and combats osteoporosis by restoring adequate levels of bone protecting hormones in the blood.

Quitting smoking is difficult because of the strong addictive nature of nicotine and the unpleasant withdrawal symptoms that follow sudden cessation. Fewer than 10% of smokers who want to stop can do so without help. Proven help methods include counseling, Nicotine Anonymous participation, nicotine replacement therapies (gum, nasal sprays, etc) and some anti depressant medications. Combining physician assistance with one or more of these approaches can triple the success rate compared to the “cold turkey” method.

Smoking is harmful to many of the body’s organs, including the musculoskeletal system. Stopping smoking makes good sense anytime, but quitting before planned surgery or after an orthopedic injury is essential to reduce complications. Your doctor can help.