Cigarette smoking is recognized as one of the major causes of preventable disease. Most people know that smoking is linked to heart and respiratory diseases, as well as to several cancers. However, many people are not aware that smoking has a serious negative effect on bones, muscles and joints, and that smoking often leads to poorer outcomes from orthopedic surgery.
Smoking cigarettes can mean that it will take months longer to heal a broken bone and may lead to other bone healing complications. If you smoke and you need orthopedic surgery, it would be wise to quit two months in advance to improve your recovery.
Why Are Bones Affected by Smoking?
Much like the other organs and tissues in your body, bones are nourished by blood. Nutrients, minerals and oxygen are all supplied to the bones via the bloodstream. Smoking elevates the levels of nicotine in your blood and this causes the blood vessels to constrict. Nicotine constricts blood vessels approximately 25% of their normal diameter. Because of the constriction of the vessels, decreased levels of nutrients are supplied to the bones. It is thought that this is the reason for the effect on bone healing.
Multiple studies have shown a significant difference in the healing time of bones between groups of smokers and non-smokers. The average time until complete healing was over two months longer in the smokers. Ex-smokers also had a longer healing time, but their risk was not as great as current smokers.
Fracture Risk Higher in Smokers
The strongest evidence of the effects of smoking in decreasing bone mineral density comes from a landmark study which concluded that roughly one in eight hip fractures may result from cigarette smoking. The study showed that current smokers lose bone at faster rates than non-smokers, and by age 80 this can translate into 6% lower bone mineral density, and greater fracture risk. Male smokers may be at even higher risk than women as they have a significantly greater risk of low bone density, and more vertebral fractures, than female smokers.
Smoking and the Musculoskeletal System
Smoking takes a significant toll on your musculoskeletal system. Tobacco and nicotine increase the risk of bone fractures and interfere with the healing process, according to a growing body of research. Nicotine can slow fracture healing, estrogen effectiveness and can counter the antioxidant properties of vitamins C and E.
Some of the orthopedic problems caused by smoking include:
- More severe disc degeneration
- Weakened spinal ligaments
- Reduced production of bone cells
- Faster bone loss in postmenopausal women
- Fractures take longer to heal
- Rotator cuff surgery is less successful
- Longer healing time for surgical incisions
- More post-surgery complications
- Delayed spinal fusion
In addition there are other factors which may place smokers at an increased risk for osteoporosis apart from their tobacco use. People who smoke tend to be thinner than nonsmokers, may be less physically active and have poor diets. Women who smoke also tend to have an earlier menopause than nonsmokers.
However, quitting smoking seems to improve the healing process in most cases, except for long-term, heavy smokers who have permanent artery damage, according to the researchers. Those with permanent artery damage due to smoking may not heal easily when a peripheral part of the body is involved, since blood supply may be poor there.
Smoking and Spinal Fusion Surgery
Spinal fusion surgery is often used to treat disk disorders in the neck and the lower back. Two or more of the small bones in the spinal column (vertebrae) are “welded” together with bone grafts and internal devices, such as metal rods.
The success of the surgery depends on how well the bones heal into a solid unit. A successful spinal fusion can reduce pain and improve the patient’s ability to perform activities of daily living.
What This All Means
The effect of smoking on your health is well known to have a significant negative impact. If you sustain an injury to your bone, including any type of fracture, it is of utmost importance that you do not smoke. Doing so will decrease your chances of recovering completely, lengthen the time you spend healing, and make it less likely that you will be satisfied with your outcome.
If you are going to have orthopedic surgery, your doctor is likely to recommend quitting smoking weeks to months in advance. If you can be an ex-smoker by the time you have surgery and you don’t smoke during recovery, it may improve your healing time and surgical success.
Contact Ventura Orthopedics Today
If you are concerned about your bone health, our specialists are always willing to help you reach your optimal health. Osteoporosis is a very serious disease.
To learn more about bone health or to schedule an appointment with one of our specialists, call us at 800-698-1280.