Obesity and Back Pain - Understanding the Connection

Introduction

Obesity is one of the major health issues of modern times. Almost 18 percent of adults worldwide suffer from excessive weight gain or obesity. Obesity may cause several health problems, like hypertension, obesity, and cardiovascular diseases. Apart from these, a large number of obese people suffer from back pain. Individuals with obesity have a 33 percent higher likelihood of suffering from low back pain, as well as a 35 percent increased chance of experiencing severe and intense pain. Moreover, they are up to 43 percent more likely to develop chronic low back pain compared to those with a lower body fat percentage. These statistics highlight the significant impact of obesity and back pain.

What Is Obesity?

Abnormal weight gain or excessive fat accumulation in the body is known as obesity. About 890 million adults worldwide suffer from obesity. In obese patients, the BMI (body mass index calculated from height and weight) is more than 25. It is a chronic, complex condition that may cause disorders like hypertension, diabetes type II, and cardiovascular disease.

What Is the Connection Between Obesity and Back Pain?

There are several mechanisms responsible for lower back pain and obesity.

These factors are,

1. Mechanical and Physical Changes: One of the major problems associated with obesity is postural changes due to excessive weight gain. Excess weight causes increased loading into the joints and the spine. This larger amount of loading force leads to compression of joint space. As a result, reduced joint space destroys cartilage and causes degenerative disk disorders. This causes compression of intervertebral disks and herniation of the disks. Intervertebral disc degeneration is linked to damage to surrounding structures, including ligaments, joints, and vertebral muscles. This results in functional changes and increased vulnerability to injuries. This leads to osteoarthritic degeneration. The strength of yellow ligaments decreases, leading to hypertrophy and protrusion of the ligaments into the spinal canal, resulting in the narrowing and compression of neural structures.

2. Effects of Chemical Mediators and Inflammation: Excessive amounts of fatty tissue in the body are linked to various metabolic changes. Fatty tissue causes alteration in the function of the various glands. Leptin, one of the key chemical mediators secreted from fatty tissue, is responsible for changes in the hypothalamic-pituitary-gonadal axis, thyroid, growth hormone, and adrenal hormone. As a result, metabolic changes are evident. These metabolic changes cause alteration in the serum calcium levels and vitamin D synthesis.

These mechanisms, in turn, affect the bone turnover ratio and ultimately lead to bone degeneration. Excessive amounts of leptin in the body are also associated with increased joint inflammation, joint pain, and joint destruction. Other obesity hormones, like ghrelin and galanin are related to increased pain perception and lower back pain.

Another important mechanism that is linked to obesity and lower back pain is an increase in inflammatory mediators. Obesity is responsible for chronic, low-grade systemic inflammation.

This causes increased tumor necrosis factors, interleukins, and C-reactive proteins. These mediators activate different inflammatory cells, like macrophages and lymphocytes. These cells are associated with increased bone resorption and the loss of bone minerals. These osteoporotic changes lead to the softening of bones and compression fractures of the spinal vertebrae. As a result, changes in the spinal architecture are seen.

1. Effects of Diet: Obesity is linked to diet. Obese people often consume more fast foods, junk foods, and oily foods. Also, habits like smoking and alcoholism are prevalent among obese people. Such food items are associated with nutritional deficiencies in the body. Low calcium, magnesium, and vitamin D levels are responsible for increased bone destruction. Also, these food items are associated with generating inflammatory mediators in the body, which again cause bone destruction.

What Are the Complications of Back Pain?

One of the common complications associated with obesity is postural changes. In most cases, a forward-bending posture is seen due to spinal column compression, known as kyphosis. Back pain from obesity affects various regions of the spinal column, including the cervical, thoracic, lumber, and sacral regions.

The symptoms of the complications are;

1. Presence of chronic neck pain. People often complain of difficulty moving their heads.

2. Pain in the neck region often radiates to the back and sides of the head; in some cases, it may radiate to the shoulder region.

3. Difficulty moving the hand and numbness in the hand and fingers.

4. Lower back pain often causes difficulty sitting, standing, and walking.

5. Pain during walking and numbness in the sides of the legs are joint issues.

6. Muscle pain similar to the compression of the muscles can be observed.

How to Treat Back Pain in Obesity?

As already discussed, back pain in obesity is due to excessive weight gain and the presence of excessive fatty tissue in the body. Weight reduction is one of the main treatment options in such cases. Various exercises for low back pain help to reduce symptoms and weight. Aerobic exercises like walking, swimming, and running can help burn calories and reduce weight.

Such exercises also reduce pain and the production of inflammatory mediators. Aerobic exercises can improve postural defects. Strength training and resistance training improve muscle strength and muscle mass. This kind of exercise also affects the metabolic rate of the body and muscles. Researchers say combining resistance training and aerobic exercises is useful for lower back pain. High-intensity interval training includes repeated bouts of high-intensity effort followed by varying recovery times.

Repeated short bouts of high-intensity exercises are responsible for the increased cardio-pulmonary activity. This increases the body's metabolic activity and leads to a shift in the body’s activity. As a result, the anaerobic pathways of the metabolism are activated.

Apart from exercise, diet also plays an important role in symptomatic relief. A proper diet not only improves the nutrient supply in the body but also helps with weight reduction.

Conclusion

Obesity is one of the most common health disorders in the present condition. Obese people often suffer from complications like back pain. Mechanical changes, the production of inflammatory mediators, and dietary deficiencies mainly cause this. However, proper diet and regular exercise can relieve back pain in such patients.