Changes in Back Pain Scores after Bariatric Surgery in Obese Patients: A Systematic Review and Meta-Analysis

Abstract

Bariatric surgery produces significant and quantifiable reductions in back pain. However, there is a lack of information on the association of weight changes after bariatric surgery with changes in pain score. We aim to evaluate the impact of bariatric surgery on back pain in obese patients and to address the association between changes in body mass index (BMI) and pain score. In obese patients eligible for bariatric surgery, the changes in pre- and post-operative pain scores, assessed by the Numeric Rating Pain Scale (NPS) or Visual Analogue Scale (VAS), were considered as primary outcomes. Mean difference (MD) and their 95% confidence intervals (CI) were evaluated. Eight cohort studies were included in the analysis of 298 obese patients undergoing bariatric surgery. All studies showed a reduction in back pain, with a mean change of −2.9 points in NPS and of −3.8 cm in VAS. There was a significant reduction in back pain (NPS: (MD = −3.49) (95% CI = −3.86, −3.12); VAS: MD = −3.75, (95% CI = −4.13, −3.37)) and BMI (MD = −12.93, (95% CI = −13.61, −12.24)) following bariatric surgery. No significant relationship between BMI change and decrease in clinical scores could be established. However, it was evident that bariatric surgery had a significant effect on back pain scores in severely obese patients. Ideally, a prospective study including spinal imaging, inflammatory markers, a longer follow-up period, and larger study groups with a randomized control group needs to be performed.

A Case–Control Study of the Effects of Chronic Low Back Pain in Spatiotemporal Gait Parameters

“…With regard to the significant difference in BMI between groups, a value of 25.25 (3.61) was assessed for the case group (values greater than 25 mg/kg 2 indicates overweight) [ 2 , 28 ]. Obesity is associated with an increased risk of musculoskeletal diseases such as low back pain [ 28 ].…”

“…With regard to the significant difference in BMI between groups, a value of 25.25 (3.61) was assessed for the case group (values greater than 25 mg/kg 2 indicates overweight) [ 2 , 28 ]. Obesity is associated with an increased risk of musculoskeletal diseases such as low back pain [ 28 ]. It is a fact that in the case group, the BMI levels presented overweight values which can influence or be a consequence of CLBP because pain limits the development of physical activity.…”

“…As discussed above, the current trend in approaching CLBP is rehabilitation through exercise that can improve CLBP pain. This fact is considered relevant because gait is part of daily life of the individual, and it is an important physical activity in relation to the maintenance of an optimal state of health [ 28 , 29 , 30 ].…”

“…As a result, assessing gait-altering factors can help improve CLBP. Sensor-based technology is a practical way to detect the decline in gait and balance [ 28 , 29 , 30 ]. The assessment and treatment of CLBP is important; the analysis of factors that can improve this syndrome is considered essential to prevent gait adjustments and to promote earlier intervention and reduce sedentary lifestyles.…”

Management of severe low back pain with a focused vibro-percussion wave treatment: A Case Report

“…A factor in low back pain may be obesity resulting in stress on the musculoskeletal system. As a result bariatric surgery is conducted in some cases with positive results [4]. However, there is also a known effect on some patients that a gastrectomy is followed by increasing low back pain resulting from the change in intra-abdominal pressure, spinal loading, and a decrease in stability of the spine [5].…”