The link between obesity and back pain may seem obvious. You might assume that carrying around excess weight is the sole reason for back pain in people with obesity. However, there is actually a lack of clinical studies on the correlation between these two conditions. Having excess weight around the midsection may put more strain on the back and joints, but this has not been scientifically proven. Which is not to say that there is no link between obesity and back pain. Preexisting conditions and specific lifestyle choices—combined with obesity—can contribute to back pain.
OSTEOARTHRITIS AND OBESITY
Osteoarthritis occurs as we age and the cartilage that supports the healthy movement of our spine breaks down. At the same time, the spongy discs that provide cushioning in our spine become drier and stiffer. The result is inflammation and/or stiffness in the back. Back pain that is caused by osteoarthritis can be due to tears in the discs of the spine or pressure on nerves being compressed by the vertebra that are too close together. When obesity is present, the chances of developing osteoarthritis increase, although not for the reasons you might think.
CHRONIC JOINT INFLAMMATION
The low-level chronic inflammation caused by obesity affects all the joints of the body—not just the spine—but is detrimental to the back. Dr Robert Mooney, professor of pathology and laboratory medicine at the University of Rochester in New York, studies obesity and osteoarthritis. Through his research, Mooney has discovered that abnormal changes in the metabolisms of the mice used in the study lead to an increase in the development of osteoarthritis. Excess weight alone could not be labelled as the sole contributing factor. Mooney’s team is now trying to see if there is a link between the proteins that fat cells secrete and cartilage damage. Mooney is quick to point out the link between obesity and osteoarthritis is a complicated one.
DEGENERATIVE DISC DISEASE
Degenerative disc disease often goes hand in hand with osteoarthritis. The cartilage of the vertebrae breaks down as the spinal discs become flatter. It is common for bone spurs to develop—the body’s natural attempt to stabilize the spine—as a result of too much friction between the vertebra. Just like osteoarthritis, degenerative disc disease puts more pressure on the nerves of the back and, thus, can result in back pain. In people who are obese, the onset of degenerative disc disease can be hastened through a lack of regular movement/exercise. That being said, a lack of exercise can also be a factor in the onset of degenerative disc disease in people who are not obese.
EXERCISE AND OBESITY
Obesity most commonly occurs as a result of poor diet and a lack of physical activity. While pre-existing conditions and genetics sometimes contribute to the onset of obesity, these are rare cases. When it comes to exercise, the excess body weight that obese people carry around can make moving difficult and even painful. However, exercise is an important part of maintaining a healthy, pain-free back. Lack of movement leads to back stiffness, tension and an increase in the chances of straining a muscle. Back pain, in turn, makes moving the body even less enjoyable. This cycle will ultimately continue until the excess weight that is making movement difficult is lost.
Whether obese or just a little heavy, diet is the key factor that affects body weight and weight loss. Exercise is important but is only about 20% responsible for helping you lose weight. The other 80% has to do with what you eat and how much you eat. Not all calories are created equal and there is a correlation between the consumption of refined sugars and ‘bad fats’ and obesity. Poor diet, paired with little to no exercise, creates chronic inflammation in the body. This means you are more susceptible to back pain, ranging from the severe—such as osteoarthritis—to the more mild type of pain that comes when the body is tight from being mostly immobile.
ONE SIZE DOESN’T FIT ALL
While obesity is now widespread, there is still a lot more research to be done in order to fully understand this condition and how it affects back pain. The simple answer is to lose weight but the reality is, there are a lot of factors contributing to the back pain in people who are obese. Some of the pain may need weight loss in order to be treated while other pain might be able to be alleviated with a little more daily movement. There is no one-size-fits-all solution when it comes to obesity and back pain. However, the key to succeeding at making change for the benefit of your back is to change things gradually. Gradual change is sustainable and will likely not cause you back any additional pain.
Blahd, Jr, William H., MD, and Robert B. Keller, MD. “Low Back Pain-What Increases Your Risk.” WebMD. November 14, 2014. Accessed December 05, 2016. http://www.webmd.com/back-pain/tc/low-back-pain-what-increases-your-risk.
Erdmann, Jeanne. “Osteoarthritis and Obesity.” Osteoarthritis and Obesity. Accessed December 05, 2016. http://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/osteoarthritis-and-obesity.php.
“Obesity.” Obesity – Mayo Clinic. June 10, 2015. Accessed December 05, 2016. http://www.mayoclinic.org/diseases-conditions/obesity/basics/definition/con-20014834.