A Deeper Dive Into How Nicotine Damages Your Spine

After my recent conversation with Mel Robbins went viral on Instagram, I wanted to take a moment to go deeper into the topic that surprised so many people. In the clip, Mel asked what I personally avoid to protect my spine. My immediate answer was simple: no nicotine.

Most people do not realize how strongly nicotine impacts spinal health. When I tell patients this in the office, they often look at me the same way many of you probably did online. Shocked. Curious. Concerned. So let’s walk through the science together.

Why Nicotine Is So Hard on Your Spine

Nicotine is not just a habit that affects the lungs or the cardiovascular system. It affects spinal aging, disc health, and chronic pain in very real ways.

1. Nicotine reduces blood flow to your discs

Nicotine is a vasoconstrictor, which means it tightens blood vessels. Your spine relies on steady blood flow to deliver oxygen and nutrients to the discs and surrounding tissues. When circulation is consistently reduced, your body cannot repair micro-injuries as effectively.

2. Your discs already have limited circulation

Spinal discs naturally receive less blood flow than other tissues. Anything that restricts circulation further increases the risk of degeneration. This is one reason nicotine users often show faster disc wear on imaging.

3. Nicotine increases inflammation

Inflammation is a major driver of pain. Nicotine elevates inflammatory markers throughout the body, which can worsen back pain and prolong recovery.

4. This is not something surgery can reverse

Mel asked if long-term nicotine-related degeneration can be corrected surgically. The answer is no. Surgery can fix structural problems, but it cannot undo years of slowed healing and restricted blood flow.

A Slow Process, Not a Single Injury

Nicotine-related spine damage builds slowly as your body misses repeated opportunities to heal fully. Over time, micro-injuries accumulate, discs thin, and pain becomes more persistent. The good news is that healing improves once nicotine is removed from the system.

Why I Wanted to Share This With You

I expected this topic to resonate, but the response was larger than I imagined. As of this writing, more than 121,000 people engaged with the clip because the information was surprising, practical, and rarely explained.

The full podcast conversation covers so much more, including:

• How I went from caregiver to neurosurgeon to losing over 85 pounds and rebuilding my own health, and what that taught me about sustainable change.
• My deeply personal story on why I became a spine surgeon and why this work matters to me.
• The everyday habits that quietly damage your spine and speed up aging.
• The biggest posture and movement mistakes most people make.
• What tech neck is and how to reverse it.
• How to sleep for better spine health, including the most supportive positions and pillows.

These are the topics that can change how you feel today and shape your long-term mobility and independence.

If the clip sparked your curiosity, the full episode goes much deeper and gives you practical strategies you can start using immediately.

Watch the Full Conversation

You can watch my entire discussion with Mel Robbins here. It is one of the most honest and practical conversations I’ve had about spine health, chronic pain, and the daily habits that truly move the needle. I hope you enjoy watching it as much as I enjoyed being part of it.