Obesity Limits Success of Back Pain Treatments, Study Finds

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Being overweight doesn’t just increase your risk of back pain, it limits your potential to improve with treatment, according to recent research. A new study showed that obese patients have fewer improvements with back-pain treatment than patients who aren’t obese.

The study included 1,190 participants receiving treatment for lumbar disc degeneration, a common cause of sciatica and back pain. Based on body mass index (BMI), a total of 336 patients were considered obese and 854 were not obese.  Researchers evaluated the patients for initial pain and disability levels and conducted a four-year follow-up to determine the progress of treatment.

They found that obese patients had significantly fewer improvements than non-obese patients, regardless of whether or not they received surgery. Among patients that did undergo an operation, obese patients had less improvements on both the Sciatica Bothersome Index and the Low Back Pain Bothersome Index. Complication and re-operation rates were similar for both groups, but obese patients tended to have a slightly longer operation times and lengths of hospital stay. Although obese patients did show signs of improvement, researchers concluded that they did not experience the same clinical benefits from treatment as non-obese patients.*

These findings come at the heels of another new study suggesting a potential mechanism behind the back pain-obesity link.  The research suggests that there may be a close relationship between back pain, obesity, and systemic inflammation.

Researchers from Ohio State University analyzed data from 15, 322 participants of the National Health and Nutrition Examination Survey (NHANES). The researchers discovered that people with signs systemic inflammation were more likely to suffer from back pain. This pattern was especially pronounced in obese people, with elevated inflammation more than doubling the risk that an obese person experienced back pain. In general, obesity also elevated back pain risk. Although more research is needed to understand this association, it’s possible that obesity could worsen the systemic inflammation linked to back pain.

Previous research has showed that losing weight can significantly improve symptoms in patients suffering from sciatica and back pain. A doctor of chiropractic or other health provider can counsel you on using exercise, nutrition, and weight loss to reduce symptoms of back pain.

*Note: In the study by Rihn et al., patients who underwent surgery had better improvements than patients who received non-operative treatment. Despite these findings, previous studies have suggested that a number of non-surgical treatments are successful in treating back pain, and may help patients avoid the costs and risks of surgery.

References

Briggs MS, et al. The Relationships of C-Reactive Protein and Obesity to the Prevalence and the Odds of Reporting Low Back Pain. Archives of Physical Medicine and Rehabilitation 2012; pii: S0003-9993(12)01187-2. doi: 10.1016/j.apmr.2012.11.026.

Rihn JA, et al. The Influence of Obesity on the Outcome of Treatment of Lumbar Disc Herniation: Analysis of the Spine Patient Outcomes Research Trial (SPORT). The Journal of Bone and Joint Surgery 2012; doi: 10.2106/JBJS.K.01558.

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