Back Pain and Obesity: A Recurring Cycle

— By Andrea M. Pampaloni, Ph.D.

Most Americans experience back pain at some point in their lives, but the likelihood is significantly higher in people with obesity and can lead to muscle spasms or bulging or ruptured discs.

Back pain is a common and costly condition, with nearly 80 percent of adults experiencing lower back pain at some point in their lives, and around eight percent living with chronic back pain. Obesity and low physical activity can exacerbate the strain, causing muscle spasms, bulging, or ruptured discs.

Complications from Obesity

The risk of developing some type of spinal pain as a result of obesity or physical inactivity is high. Lower back pain is significantly higher in patients with an elevated body mass index (BMI) and increases with each BMI category. People with overweight and obesity are more likely to develop lower back problems and intervertebral disc disorder, though the specific mechanisms behind these positive associations are not fully understood. A possible link between obesity and disc degeneration of the spine also has been found among obese patients with chronic inflammatory conditions.1

Additionally, C-reactive protein (CRP) rises in reaction to inflammation in the body, a common condition in people with obesity, and people who are inactive had 15 times the CRP compared with those who maintain adequate physical activity levels. Obesity also is significantly related to erythrocyte sedimentation rate (ESR), which is strongly related to CRP. (An erythrocyte sedimentation rate [ESR] is a type of blood test that measures how quickly erythrocytes [red blood cells] settle at the bottom of a test tube that contains a blood sample. Normally, red blood cells settle relatively slowly. A faster-than-normal rate may indicate inflammation in the body.2) The relationship between the outcomes associated with elevated CRP or ESR extends to patients who are physically inactive or have obesity. In addition to strain, people with obesity are at 48 percent higher risk of sustaining an injury as a result of spinal issues. Since people with obesity often have difficulty engaging in physical activity, particularly when experiencing back pain, the cycle of weight gain and back pain can become constant.

Relief through Weight Loss

A recent study comparing weight loss using a Very Low Calorie Diet (VLCD) and a food-based diet and found the VLCD to be more effective and greater sustained weight loss.3 With that said, weight loss is a necessary step to help alleviate the pain and potential physical limitations associated with back pain. Losing even a small amount of weight relieves pressure on the spine and reduces inflammation and the risk of osteoarthritis, and awareness of these benefits may provide motivation to initiate preventive measures. A structured VLCD, therefore, can be used in conjunction with medical supervision for safe and rapid weight loss to treat a multitude of issues, including back pain.

Sources:

  1. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis
  2. https://medlineplus.gov/lab-tests/erythrocyte-sedimentation-rate-esr/
  3. Effectiveness of a Total Meal Replacement Program on Weight Loss: Results from the OPTIWIN Study

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