back pain and obesity

Obesity and Back Pain

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Last updated on 24 Jan 2019

Most people know that obesity contributes to the development of heart diseases, diabetes, high blood pressure and colon cancer. Did you know that obesity has a connection with back pain?

Whether obesity is the cause or aggravator to lower back pain, it is clear that the excess weight does no good to the back. When a person is obese, any extra weight creates added pressure as well as added work for the muscles. From a statistical point of view, there are multiple research studies that indicate a strong relationship between excess weight and lower back pain.

Can reducing weight help in back pain?

People who are overweight/obese and suffer from back pain may not be aware that their excess weight is actually contributing to their back pain. Here is how it works:

  1. The spine is designed to carry the body’s weight and distribute the loads encountered during rest and activity.
  2. In order to compensate for extra weight, the spine can become tilted and stressed unevenly.
  3. As a result, overtime, the back may lose its proper support and an unnatural curvature of the spine may develop.

One region of the spine that is most vulnerable to the effects of obesity is the lumbar spine – which forms the lower back.

Anything that reduces this extra, is likely to aid the process of reducing back pain.

How to prevent obesity related back pain?

Prevention is better than cure. Take action:

  • Start walking for at least 30 minutes daily from today itself.
  • Keep checking your weight every month and maintain a healthy diet. If needed, consult a dietitian
  • Consult a physiotherapist at ReLiva, to assess your muscular strength and flexibility and get started with the core exercise program to strengthen your core muscles.

How to recover from low back pain?

Obesity and recovery from low back pain can be attained at ReLiva Physiotherapy with a two-pronged approach: pain management and weight management.

1. Pain Management:

Our Physiotherapist will assess and guide you with the treatment protocol. Physiotherapy offers a plethora of options for reduction of pain, such as

  • Electrotherapy modalities
  • Exercises: postural correction exercises, strengthening and stretching exercises
  • Ergonomic advice

Once pain is under control, you progress to strengthen your core muscles [Reliva has a special Core Strengthening Program for LBP prevention]

2. Weight Management:

You can also consult a dietitian at ReLiva for weight reduction and obesity control.

How does obesity cause pain?

The relationship of obesity with pain can be understood in 2 ways:

1. Pro inflammatory state

Pain is indicative of inflammation.

Adipocytes are cells in the body that store excess fat. Naturally, the number of these cells increases in the body due to obesity. This affects the way liver responds to the production of chemical mediators, which in turn interact with the nervous system to create a sensation of pain.

As a result, an obese person is in a state highly susceptible to inflammation and highly sensitive to pain.  

2. Increased mechanical stresses

Central obesity (increased fat deposition around the abdomen) causes the centre of gravity of the body to shift forward.  The normal convex curvature of the lumbar spine, therefore gets exaggerated (hyperlordosis).

Increased fat deposition in the buttocks and pelvis can cause similar changes in the anatomy of the pelvic region, giving rise to discomfort and ultimately pain.

Did you know that pain can also cause obesity?

The relationship between obesity and pain can be two-ways.

1. Sedentary lifestyle

The presence of pain naturally discourages a person from physical activity. In chronic pain conditions like fibromyalgia, there is even an early onset of fatigue. This makes pain suffering individuals to gradually adopt a sedentary lifestyle, which is one of the most important and known risk factor and contributor to obesity.

2. Eating analgesia

Studies have shown that eating pleasurable foods has an analgesic effect. Stimulation of the descending modulatory pathway from the periaqueductal grey matter is suggested to be integral to this response. Endogenous opioids are also involved in this phenomenon. It is suggested that pleasurable eating stimulates these components in order to inhibit the sensation of pain.

Is back pain only age and weight-related?

It is true that with age, body tissues can cause changes to spinal anatomy. However, if you are overweight/ obese, chances are you have or will have back pain. You may already have or develop one of the following conditions that can cause back pain.

1. Unhealthy posture

The uneven load on the spine due to obesity causes its curvature to alter resulting in Scoliosis, kyphosis and lateral pelvic shifts. This results into changes in our posture in order to keep up with our daily activities. Therefore, an unhealthy posture can contribute to low back pain or sciatica (low back pain radiating down the leg). Physiotherapists at ReLiva are expert in assessing your posture and can advise you on the changes you may need.

Related Reading: What’s causing your back pain? Is it poor posture

2. Osteoporosis

A sedentary lifestyle coupled with unbalanced diet can affect the density or strength of the bones and an extra load is taken up by the weakened back and core muscles leading to back pain.

Related Reading: Osteoporosis : All You Wanted To Know

3. Low muscular endurance and weakness

ReLiva Physiotherapy could plan an appropriate exercise plan for you to address specific muscular weakness which would help with your chronic back pain.

4. Poor flexibility of the muscles

Extra load on the muscles makes it weak over time.  The muscles become tight to compensate this deficit and may cause back pain. Tight muscles may even form fibre nodes within/ taut band which is called as trigger points which can also cause back pain or refer pain to different site as well mimicking a nerve pain.

What else can obesity lead to?

Apart from back pain, obesity can also result in low cardiac endurance: owing to the inactive lifestyle, an overweight/obese person gets easily fatigued and breathless making it a vicious cycle where the person becomes more inactive and prone to vascular diseases like varicose veins, deep vein thrombosis, heart diseases etc and metabolic diseases like diabetes.

Related reading:
Improving heart health

This article is based on the contribution from Dr Madhura Bhagat (PT) . Dr Madhura specialises in musculo- skeletal physiotherapy and practices her profession with dedication and a smile.


Related Reading:

Back Pain – Causes, Self Care, FAQ and Home Exercise

Neck Pain : Managing at Home 


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