Smoking or sitting: which is worse for your spine?

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Last week we posted a poll on our Instagram stories about whether or not our audience thought certain habits were bad for their spine health, specifically the discs and joints. The results were interesting.


Poll 1: 72% of people thought that sitting was worse for your spine than smoking (6%), using a smartphone (11%), or lifting weights (11%).
These are somewhat surprising results.

It seems that we don’t think sitting is all that good for our backs. A few years ago I recall reading a headline that said something along the lines of “Sitting is Worse than Smoking”. Why do we perceive sitting as being so bad for our back (or our health) and is it really worse than smoking?

Smoking x Sitting

Some recent research worth considering:

smoking 1

This paper found that the relationship between sitting to back pain or back problems was not so straightforward:

“Sustained pressure under the buttocks due to prolonged, uninterrupted sitting could be reduced by varying posture (Søndergaard et al., 2010; Vergara and Page, 2002; Zemp et al., 2015, 2016c, 2019) by means of e.g. regular pelvis rotations (van Geffen et al., 2008). Moreover, since continuous compression on an intervertebral disc can result in reduced disc nutrition (Kingma et al., 2000; Pynt et al., 2001) frequent postural movements are also recommended through lordosis and kyphosis. In this manner, sufficient metabolic balance of various musculoskeletal structures can be supported, including a reduction of ischaemic effects due to prolonged static sitting (Reenalda et al., 2009; Todd et al., 2007). “

It seems that sitting itself may not be the problem. Those who sat similar amounts of time but changed positions regularly, even micro-changes, had better outcomes and were less likely to develop problems. 

Another study:

“…findings suggest that sedentary employees are exposed to increasing occupational hazards such as back pain and mental health issues. Strategies should aim to reduce sitting time with planned and feasible physical activity interventions to be incorporated into the workplace health promotion policy to help prevent back pain, back injuries, and mental health complications.”

So we are starting to get that maybe sitting isn’t the biggest thing to worry about as opposed to the lack of movement. Is this enough to rival smoking? Let’s have a look at what research says about how smoking may influence our spine health…

Smoking tobacco can contribute to problems in the discs and other musculoskeletal structures in several ways (keep in mind that these effects are systemic and not specific only to the spine):

1- Reduced Blood Flow:

Smoking narrows blood vessels and reduces blood flow throughout the body, including to the spine. This diminished blood flow can impair the delivery of oxygen and nutrients to the intervertebral discs, leading to degeneration and weakened tissue.

2- Decreased Nutrient Supply:

The intervertebral discs require a steady supply of nutrients to maintain their structure and function. Smoking can interfere with the absorption and utilization of essential nutrients, further compromising the health of the discs and surrounding tissues.

3- Increased Inflammation:

Smoking is known to trigger inflammation throughout the body. Inflammation can exacerbate existing spinal conditions and contribute to pain and dysfunction in the discs and surrounding structures.

4- Weakened Immune Response:

Smoking weakens the body’s immune response, making individuals more susceptible to infections and slower to heal from injuries. In the spine, this impaired immune function can hinder the body’s ability to repair damage to the discs and vertebrae.

5- Accelerated Degeneration:

Research suggests that smoking is associated with accelerated degeneration of the intervertebral discs. Smokers may experience disc degeneration at a younger age and with greater severity compared to non-smokers.

6- Impaired Healing:

In the event of spine-related injuries or surgeries, smoking can impede the healing process. It may lead to delayed wound healing, increased risk of complications, and poorer outcomes following spinal procedures.

In addition to the above claims, a recent paper found that despite reporting HIGHER levels of physical activity in the smoker group the incidence of each of the four spinal diseases (intervertebral disc disease, spinal stenosis, spinal instability, and spondylolisthesis) was also HIGHER in the smoker group.

My suggestions related to the poll:

  1. If you are a smoker and are worried about current pain or developing future problems, quitting is probably your best bet rather than looking for the ideal fitness routine. They say you can’t out-exercise a bad diet and the same is true for a smoking habit. 
  2. If you sit a lot, don’t worry so much about having a “perfect posture” as it’s likely not going to solve all your problems and I would be impressed if you could do it for 8 hours straight. Concern yourself more with changing positions regularly. By this I mean even small changes like shifting your weight to your other bum cheek or crossing one leg over the other, going from sitting to standing for a bit, incorporating a small rubber balance disc into your chair for a few minutes to do some pelvic tilts, going on a 1-minute walk every 30 minutes, take 2-minute breaks every so often to do some movement or mobility exercises, sit on an exercise ball for a bit, slouch for a bit, sit up straight for a bit, etc. You get the idea.
  3. Being on a smartphone: we can similarly interpret this as sitting. It isn’t so much the use of the phone rather than the static nature combined with the position and the prolonged use.
  4. Lifting weights: A form of physical activity that can pose a risk for certain problems and a benefit for others. Overall, if done correctly is an immensely beneficial habit for spine health. It is important to understand that lifting weights for an hour a few days a week, while very helpful, likely does not replace the need to move more through the day when you’re not at the gym. I do not think we should consider the habit “bad for the spine” and is already included in most health guidelines as an essential habit for good health. 

Next week we will dive into the “beneficial habits” poll. To participate in our polls, follow us on Instagram and keep an eye on our posts.

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