SMOKING AND INTERVERTEBRAL DISC HERNIATION

A cigarette is an enemy of the spine. By inhaling cigarette smoke, you expose your body to a significant dose of nicotine. Nicotine is primarily a vascular poison—it causes spasms of the blood vessels that supply the spinal cord and spinal centers.

The discs that separate adjacent vertebrae have very poor blood supply. Smoking further disrupts blood circulation, making it impossible for these discs to absorb the nutrients they need to stay healthy.

What follows is predictable: the tissues of the intervertebral discs lack nutrition, degenerative processes develop within them. And then, on some unfortunate morning, a person may find themselves unable to get out of bed, complaining of sharp pains in the spine.

HOW SMOKING AFFECTS THE DEVELOPMENT OF INTERVERTEBRAL DISC HERNIATION

Researchers have long noticed that smokers experience a decrease in bone mass. This occurs due to several mechanisms:

1. Nicotine, ammonia, and formaldehydes found in cigarettes trigger increased breakdown of estrogens in the liver and enhanced production of parathyroid hormone by the thyroid gland. This leads to calcium being leached from cartilage and bone tissue into the blood plasma and suppresses the formation of new bone cells. As a result, bones become more fragile and brittle, they hardly grow or strengthen, which with age predisposes to osteoporosis and, consequently, intervertebral disc herniation. According to the 2004 report by the U.S. Surgeon General, accumulated scientific data is sufficient to conclude a confirmed causal relationship between smoking and decreased bone density.
2. Tobacco exposure weakens vertebrae, making them less healthy and insufficiently mineralized, because they receive poorer blood supply and have less effective bone-forming cells. Therefore, the spine of smokers is more sensitive to traumatic impacts. It is traditionally believed that consuming calcium-rich foods, especially dairy products, helps maintain bone mineral content. It is known that dietary calcium plays a protective role in maintaining bone density in elderly individuals. However, smoking negates this protective effect. A study conducted in Finland found a linear relationship between dietary calcium intake and spinal bone density in non-smokers. This relationship was absent in smokers and former smokers.
3. Smoking disrupts vitamin D metabolism. As a result, smokers require an increased intake of this vitamin. Without it, hypovitaminosis may develop, leading to reduced calcium absorption in the intestines, which affects calcium levels in the blood and bones. Smoking lowers bone density. A meta-analysis conducted in the UK, summarizing data from 86 studies involving 40,753 participants, showed that smokers had reduced bone density at all examined sites.
4. Carbon monoxide in tobacco smoke binds with hemoglobin to form carboxyhemoglobin. This bond is so strong that the hemoglobin can no longer transport oxygen. This causes hypoxia (oxygen deficiency), which harms all organs and tissues, including bones.
5. Nicotine and benzopyrene stimulate increased synthesis of corticosteroids in the adrenal cortex. It is known that elevated levels of adrenal hormones (cortisol) have a destructive effect on bone tissue.
6. It should also be noted that the most intense bone formation occurs before the age of 20. Smoking during childhood and adolescence naturally affects bone development. A study tracking the health of New Zealand children from birth to 18 years between 1972/1973 and 1990/1991 found that daily smoking during adolescence increased the risk of fractures by an average of 43%. (Jones IE, Williams SM, Goulding A. Associations of birth weight and length, childhood size, and smoking with bone fractures during growth: evidence from a birth cohort study. Am J Epidemiol. 2004 Feb).
7. Nicotine and hydrogen cyanide reduce collagen levels, making soft tissues and cartilage less elastic and resilient. When cartilage, vertebrae, and intervertebral discs weaken, the chances of developing an intervertebral disc herniation or disc bulging increase dramatically.
8. According to experts, smoking reduces bone density, exposing vertebrae to a higher risk of osteoporosis, spinal arthritis, and other degenerative spinal diseases. Therefore, when experiencing back pain or during an acute phase of the condition, smoking should be completely stopped or the number of cigarettes smoked should be significantly reduced.
9. Several researchers have established a connection between smoking and lower back pain. In the early 1990s, hypotheses were proposed that the impact of smoking on the spine and the development of herniated discs was due to the unhealthy lifestyle of smokers, increased intra-abdominal pressure caused by frequent coughing, osteoporosis, or insufficient nutrition of the intervertebral discs, which makes them more sensitive to mechanical factors and injuries.
10. Insufficient nutrition, in turn, can be explained by carboxyhemoglobinemia (since hemoglobin bound to carbon monoxide ceases to deliver oxygen to tissues), vasoconstriction (since narrowed blood vessels limit the supply of blood containing nutrients and oxygen), sclerotic changes in the vessel walls (which also hinder blood flow through vessels coated internally with sclerotic plaques), and changes in fibrinolytic properties and blood viscosity (the formation of fibrin clots is another reason for poor blood supply).
11. Back pain can be explained by processes such as degeneration of intervertebral discs, ischemia, apoptosis (programmed cell death), incorrect synthesis of macromolecules that make up the nucleus pulposus of the intervertebral disc, and an imbalance between disc matrix proteinases responsible for breaking down proteins necessary for renewal and their inhibitors. Alongside the development of hernias, it has been found that the initially avascular disc becomes vascularized—that is, blood vessels appear within it. It is highly likely that following degeneration and the formation of blood vessels in the intervertebral disc, proteolytic enzymes (which break down proteins) from the blood, whose levels are elevated in smokers, enter the disc and accelerate degeneration.
12. To study the mechanism of this phenomenon, Japanese scientists conducted an experimental study on the effects of nicotine on intervertebral discs in rabbits. Exposure to nicotine for eight weeks led to necrosis and hyalinization, as well as densification of the nucleus pulposus in all rabbits in the experimental group. Damage was also observed in the fibrous ring and its nourishing blood network. The vessels calcified, their walls thickened, endothelial cells underwent necrosis, and new vessels became stenosed.
13. Recent studies have found an increased risk of spinal and intervertebral disc problems in individuals exposed to tobacco smoke during childhood.
15. WHAT EFFECT DO ALCOHOLIC BEVERAGES HAVE ON INTERVERTEBRAL DISC HERNIATION?
16. Doctors have diagnosed intervertebral disc herniation and recommended leading a healthy lifestyle. Of course, recommendations related to therapeutic exercise and lifestyle are understandable. But what about alcoholic beverages? Does this mean you can no longer have a little beer?

HOW ARE INTERVERTEBRAL DISC HERNIAS AND ALCOHOL RELATED?

It is often heard that alcohol consumption is contraindicated for heart diseases, brain conditions, pregnant and breastfeeding women. But what about those who suffer from back pain? According to statistics, up to 85% of the population suffer from musculoskeletal disorders, so the question of alcohol’s impact on intervertebral discs is very relevant.

EFFECT OF ALCOHOLIC BEVERAGES ON THE SPINE

Let’s consider how spinal hernias and alcohol interact.

Ethanol (ethyl alcohol) affects disc protrusion in two ways:

• direct
• indirect

DIRECT EFFECT

After consuming a dose of alcohol, the following occurs:

1. Alcohol causes blood thickening because ethanol reduces the amount of fluid in the bloodstream. As a result, red blood cells cannot deliver oxygen and nutrients properly to muscles, joints, and the cartilage of intervertebral discs. This leads to poor nutrition reaching the spinal cord and disc tissues after excessive drinking. The disc cartilage signals this shortage by causing pain. That’s why many people experience back pain after heavy drinking.
2. Alcoholic drinks, especially beer, cause the leaching of calcium ions from cartilage and bone tissues and disrupt natural processes by suppressing the formation of new bone cells. Bones become more fragile and brittle, decreasing their resistance to both static and dynamic loads. This further worsens the pathological process and creates favorable conditions for increased disc deformation. Beer is especially dangerous for lumbar spine hernias since this area bears the greatest physiological load. Beer binge drinking is also harmful after hernia surgery and adhesions, when instead of proper rehabilitation, the damaged cartilage is further destroyed. Statistics show that most beer lovers suffer from spinal diseases in the lumbar region, and less often in other parts of the spine.
3. The liver suffers from alcohol consumption. This organ regulates all metabolic processes in the body. Metabolic disturbances in intervertebral discs lead to dystrophic and degenerative changes, which may cause progression and the development of new hernias.
4. Drinking alcohol while taking painkillers can lead to side effects from medications. For example, combining non-steroidal anti-inflammatory drugs (NSAIDs) with alcohol doubles the risk of developing acute stomach ulcers and even gastrointestinal bleeding.
5. Alcoholic beverages are especially dangerous for people suffering from cervical spine hernias. Alcohol raises blood pressure, which is risky with cervical vertebrae damage. Symptoms of vertebral artery compression—such as dizziness, nausea, vomiting, and intense headaches—are worsened under intoxication.
6. Alcohol significantly reduces the effectiveness of vitamins, chondroprotectors, and drugs that improve microcirculation. These medications are prescribed to speed up cartilage tissue recovery. Therefore, alcohol consumption undermines treatment outcomes.
7. INDIRECT EFFECT
8. There is a medical term called “post-alcoholic polyneuropathies,” which refers to the indirect effects of alcohol on the human body.
9. The most common factors provoking exacerbation of herniated disc conditions include:
10. HYPOTHERMIA. Ethyl alcohol causes blood vessels to dilate, making a drunk person feel warm, often leading them to undo their outer clothing or even take off their jacket. Hypothermia triggers inflammation primarily at the site of pathological deformation, causing serious exacerbations.
11. UNCOMFORTABLE SLEEPING POSITION. For example, after excessive drinking the night before, a person might fall asleep in an awkward position. While asleep, due to impaired brain neuron function, they might not feel discomfort, but waking up in the morning can be unpleasant—back pain caused by a pinched nerve will make itself known.
12. FORCED BODY POSTURE. Few people pay attention to their posture after heavy drinking, but it matters! If you look carefully in the mirror, you might notice that the left shoulder is slightly lower than the right. This happens because the liver, trying to cope with intoxication, slightly enlarges. To compensate, a person reflexively raises one shoulder. It seems more comfortable, and easier for the liver—but this puts additional strain on the intervertebral discs.
13. APPETITE. Another indirect negative effect of alcohol on osteochondrosis and herniated discs is that alcoholic beverages increase appetite, leading to overeating, obesity, and greater stress on the spine. Eating snacks, salty, and pickled foods contributes to salt accumulation and progression of the disease.
14. These are just a few indirect reasons for exacerbations. Everyone has their weak spot: some frequently catch colds, others have pinched nerves, and under the influence of alcohol intoxication, the risk of exacerbations increases several times.
16. CONCLUSION: Can you drink alcohol with a spinal hernia? It’s hard to say definitively. One or two drinks on a holiday won’t harm the spine’s health. But regular alcohol consumption, especially beer, will worsen existing herniated disc deformities and provoke disease exacerbations.
17. HOW TO PREVENT THE PROGRESSION OF A HERNIATED DISC?
18. There is a widespread belief that a beloved cigarette can reduce pain and relieve stress caused by severe back pain. However, smoking decreases the effectiveness of herniated disc treatment.
19. Give your intervertebral discs a chance to recover—don’t burden them with nicotine poison! Walking outdoors in the fresh air will be very beneficial. Regular therapeutic morning exercises, practicing yoga, and swimming in a pool or open water will help prevent new episodes and the progression of the herniated disc.
20. Watch your diet and avoid excessively spicy and salty foods. These not only trigger another flare-up of the condition but can also lead to excess weight and high blood pressure. Enjoy life—start your day with a smile, and then troubles and ailments will pass you by.