Obesity and back pain are connected in numerous ways, each capable of being both cause and effect. In fact, one study suggests that if you are overweight you have a 12% increased chance of being diagnosed with sciatica. If you are obese, your risk increases by a whopping 31%, compared to people with a lower body weight.
Obesity and back pain – what’s your risk?
The same study that found the link between sciatica and obesity also found that obesity increased a person’s risk of lumbar sciatic pain by 23%. For people who were obese, the risk increased 40%. Lumbar sciatic pain is pain that radiates in the lower back.
It’s not just the outright risk of experiencing back pain that is an issue if you’re carrying a lot of body weight. Research suggests that you’re more likely to be hospitalized for sciatica if you are overweight (16%) or obese (38%).
Your risk of having to have spinal surgery for disc herniation also increases by an incredible 89% if you are overweight or obese. And, ironically, you also have a higher risk of complications from surgery if you are carrying excess weight. In some cases, this may mean you’re not even considered for surgery until you lose weight.
Why the link between obesity and back pain, overweight and sciatica? Let’s take a look.
It’s a simple fact of life that the force of gravity means a heavier body puts more pressure on joints. Just imagine strapping a 10 lb dumbbell to each knee and having to walk around all day. Or, consider wearing a body suit that weighs 30 lbs, 50 lbs, or even 100 lbs or more.
It’s easy to see how the extra weight can wear joints out faster and cause pain related to osteoarthritis. This is especially true if there are existing joint issues, such as spinal misalignment. An accumulation of smaller issues, plus being overweight, can conspire to create back pain, seemingly with no cause.
One particular issue, sciatica, may also be triggered by an excess of fat in the thigh. This is because the sciatic nerve travels from the lower back down the thigh and into the foot. Pressure from the piriformis muscle in the thigh can trigger sciatic nerve pain even if there isn’t a problem in the spine itself.
Physiology, fat, and back pain
Scientists have now discovered that adipose tissue (fat) contributes to the production of pro-inflammatory cytokines. Carrying an excess of body fat can, therefore, increase levels of inflammation in the body. Inflammation is not only a possible direct cause of back pain, it also leads to joint damage and long-term spine issues.
An excess of fatty tissue also decreases sensitivity to insulin, the hormone that helps get sugar into cells for use as energy or for storage. When cells become insulin-resistant, this leaves sugar in the blood, which then increases the production of free radicals and inflammatory substances.
Elevated blood sugar can also hinder healing processes and make people feel sluggish and unmotivated to exercise. Because the cells aren’t getting the fuel they need, the body responds by triggering hunger, creating a vicious cycle. Over time, excess body fat can contribute to tissue degeneration in the spine, inflammation, and slower healing.
Sadly, for some people, back pain itself can lead to obesity. This is because pain can make it harder to get regular exercise, and because some pain medications such as steroids can increase body weight. What’s more, chronic pain may lead people to resort to coping habits such as comfort eating.
What’s the answer? Well, to beat both obesity and back pain it’s smart to eat a healthy, anti-inflammatory diet, get regular exercise, and try to achieve and maintain a healthy body weight.
Obesity, back pain and exercise
Both obesity and back pain can make exercise challenging. If it’s been a while since you last exercised, make sure to talk to your doctor first. Start out slow and gradually increase how much exercise you’re doing, and the intensity of your workouts.
Walking is one of the easiest and cheapest forms of exercise. Start by walking for just 15 minutes twice a day, if possible. This might mean getting off transit a stop earlier, taking the stairs at work, or having a stroll after dinner.
Cycling is another great exercise for anyone who is overweight as it is low impact and great for decompressing the lower spine. Try cycling to the store, instead of taking the car. Form a cycling caravan to take the kids to school. Explore your neighborhood on the weekends, or just put your bike on the bus to work and cycle home at the end of the day.
Swimming is also great exercise for anyone with back pain who is also obese of overweight. Low impact and easy on the joints, swimming can be a fun family activity too, making it easier to stay motivated.
Losing a little weight (even 10 lbs) can make a dramatic difference to insulin sensitivity. In turn, this can help lower inflammation and reduce back pain. You might even find that achieving a healthy body weight can improve your energy levels, mood, and motivation!
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Shiri, R., Lallukka, T., Karppinen, J., Viikari-Juntura, E. (2014). Obesity as a Risk Factor for Sciatica: A Meta-analysis. Am J Epidemiol, 179(8):929-937.