Sports, Smoking, and Overweight During Adolescence as Predictors of Sciatica in Adulthood: A 28-Year Follow-up Study of a Birth Cohort

Abstract

Lifestyle factors such as smoking, obesity, and level of physical activity predict low back pain (LBP) and sciatica. The authors investigated whether participating in sports, smoking, and being overweight or obese at 14 years of age predicted hospitalizations due to LBP or sciatica in adulthood. In 1980, at the age of 14 years, a total of 11,399 members of the 1966 Northern Finland Birth Cohort returned the postal questionnaire. Patients from the 1966 Northern Finland Birth Cohort who were hospitalized because of LBP or sciatica were followed to the end of 2008 through the Finnish Hospital Discharge Register. Data were analyzed using Cox's proportional hazards multistate model with the Markov clock forward time scale. During follow-up, 119 females (2.7%) and 254 males (5.6%) had been hospitalized at least once because of LBP or sciatica. Among females, overweight was associated with an increased risk of second-time hospitalization for surgical treatment for sciatica (hazard ratio = 7.1, 95% confidence interval: 1.5, 34.4). Among males, smoking was associated with an increased risk of first-time nonsurgical hospitalization (hazard ratio = 1.8, 95% confidence interval: 1.2, 2.7) and second-time surgical hospitalization (hazard ratio = 3.2, 95% confidence interval: 1.2, 8.2). The authors found potentially modifiable risk factors in adolescence that predicted hospital treatments for low back disorders during adolescence and young adulthood.

Is smoking a risk factor for lumbar disc herniation?

“…Subsequent to this review, a number of emerging studies were published on the risk factors of LDH. However, results of these studies are inconsistent [8][9][10][11][12][13][14][15][16][17][18][19][20][21]. Therefore, we conducted a systematic review to access the evidence examining the association between tobacco smoking and LDH.…”

Low back pain in childhood and adolescence phase: consequences, prevalence and risk factors - a revision

“…The explanation for this relationship between smoking and LBP could be explained by reduced oxygenation of spinal structures caused by smoking [30,54], or by a long-term effect on the nervous system that aggravates musculoskeletal pain. The consumption of tobacco causes the degeneration of the intervertebral disc due to its malnutrition caused by nicotine, through the reduction of blood flow followed by local hypoxia [45,53], however this fact may not apply in childhood and adolescence.…”

“…In addition, obesity may increase the mechanical load on the spine [30,[54][55][56][57][58], increasing the compression force on the structures of the lumbar spine during several activities and decreasing the mobility of the spine, which may interfere with nutrition of the disc intervertebral [54,57,58]. In addition, obesity is often associated with dyslipidemia, which plays an important role in the development of atherosclerosis in obese individuals, which can lead to malnutrition of the intervertebral disc cells, potentially predisposing it to degeneration [54,57].…”

“…Obesity can also cause LBP through chronic systemic inflammation, as it is associated with increased production of cytokines and acute phase reactants and with the activation of the proinflammatory pathways, which in turn can lead to pain [54,57].…”

“…Several studies have found a statistically significant association between LBP and BMI [27, 46,52,54,57,58]. Mikkonen et al [41] evaluated 1,660 Finnish adolescents aged 7 to 19 years and found that overweight was associated with persistent LBP in adolescence.…”