Changes in back pain scores after bariatric surgery in obese patients: A systematic review and meta-analysis

Abstract

Objective: To evaluate if back pain scores in morbidly obese patients change after bariatric surgery. Summary Background Data: Obese patients often complain of low back pain (LBP), however the underlying mechanism is not fully understood. Recent research shows that, next to mechanical loading, the chronic low-grade inflammation that arises in obese patients is contributing to LBP due to intervertebral disc degeneration. Therefore, it is hypothesized that bariatric surgery will have an effect on the LBP in obese patients. Methods: We searched four online databases for randomized controlled trials and observational studies. In obese patients, eligible for bariatric surgery, the changes in pre- and postoperative pain scores, assessed by Numeric Rating Pain Scale (NPS) or Visual Analogue Scale (VAS), were considered as primary outcomes. Effect size (ES) and their 95% confidence intervals (CI) were evaluated. Results: Eight observational studies met the eligibility criteria. All studies showed a reduction of LBP following bariatric surgery, with a mean change of -2.9 points in NPS and of -3.8 cm in VAS. Among the patients undergoing bariatric surgery, based on a fixed effect estimated by pain assessment, the pain score decreased significantly in both groups; in NPS (ES -3.49, 95%CI [-3.86, -3.12]) and in VAS (ES -3.975, 95%CI [-4.45, -3.50]). Conclusions: From this meta-analysis, the data of back pain improvement following bariatric surgery seems encouraging. Substantial weight loss following bariatric surgery might be associated with a reduction in back pain intensity.

Examining the influence of body fat distribution on standing balance and functional performance in overweight female patients with degenerative lumbar disease

“…Previous studies have indicated that excess adipose tissue in the body can lead to chronic low-grade inflammation, resulting in pain and increased disability (Hussain et al, 2017;Kawai et al, 2021;Zheng et al, 2022). However, some research has shown that a decrease in BMI may not be associated with the severity of back pain and disability after bariatric surgery or physiotherapy treatment (Mangwani et al, 2010;Koremans et al, 2021), which is consistent with our study. Pain is the subjective experience.…”

“…Overweight is associated with many common health conditions, such as joint degeneration, increased pain, and poor daily activity performance (Pataky et al, 2014;Chen et al, 2021;Goode et al, 2022). Previous studies have reported that overweight is one of the main contributing factors of DLD (Hussain et al, 2017;Parenteau et al, 2021).…”