Self-reported hard physical work combined with heavy smoking or overweight may result in so-called Modic changes

Hard physical work in combination with either heavy smoking or overweight is strongly associated with VIP. If this finding can be reproduced in other studies, it may have consequences in relation to both primary and secondary prevention of LBP, because blue collar workers, who are most likely to experience the consequences of LBP, also are those who are most likely to smoke.