Obesity and Low Back Pain: Is There a Weight of Evidence to Support a Positive Relationship?

Roffey, Darren M.; Budiansky, Adele S; Coyle, Matthew J.; Wai, Eugene K.

doi:10.1007/s13679-013-0058-7

Cited by 20 publications

(12 citation statements)

References 98 publications

(71 reference statements)

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“…Because disorders of lipid metabolism are considered essential for initiating the long, drawn-out process of atherosclerosis development, our results are in accordance with the hypothesis that atherosclerosis of the lumbar vessels is significant as a mechanism leading to LBP. Although lipid levels may indirectly affect LBP through obesity, which has been considered to result in increased mechanical load on the lumbar structure [ 30 ], our results showed a significant relationship between LBP and lipid levels after adjustment of BMI. These results may imply the existence of another pathway contributing to the development of LBP other than obesity.…”

Section: Discussionmentioning

confidence: 57%

Association between serum lipids and low back pain among a middle-aged Japanese population: a large-scale cross-sectional study

et al. 2018

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BackgroundAbnormal lipid levels have been suggested as a mechanism leading to atherosclerosis of the lumbar vessels, resulting in low back pain (LBP). This study examined whether abnormal lipid levels were associated with LBP among middle-aged adults in Japan.MethodsThe present study included adults between 40 and 64 years old who underwent an annual health checkup. A total of 258,367 eligible participants were analyzed to investigate associations of LBP with low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C ratio. Participants were categorized into two groups according to each of LDL-C, HDL-C, and LDL-C/HDL-C ratio (LDL-C: ≥ 140 vs. < 140 mg/dL; HDL-C: ≥ 40 vs. < 40 mg/dL; LDL-C/HDL-C ratio: ≥ 2.5 vs. < 2.5). Information on LBP was obtained using a self-administered questionnaire. Logistic regression modeling was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for LBP.ResultsThe prevalence of LBP was 2.2% in men and 2.1% in women. Multivariable analysis adjusting for age, body mass index, and lifestyle factors found significant associations for HDL-C < 40 mg/dL (OR, 1.34; 95%CI, 1.20–1.48 in men; OR, 1.32; 95%CI, 1.02–1.72 in women) and LDL-C/HDL-C ratio ≥ 2.5 (OR, 1.17; 95%CI, 1.09–1.26 in men; OR, 1.15; 95%CI, 1.03–1.29 in women) with LBP.ConclusionsLow HDL-C and high LDL-C/HDL-C ratio were significantly associated with LBP in a middle-aged Japanese population. These findings might support the atherosclerosis-LBP hypothesis.

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Section: Discussionmentioning

confidence: 57%

Association between serum lipids and low back pain among a middle-aged Japanese population: a large-scale cross-sectional study

et al. 2018

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“…In the field of prevention of LBP with weight reduction due to lifestyle modification, data is scarce and general conclusions cannot be deducted 33 . However, there are findings to support the claim that a reduction of the level of systemic inflammation by means of physical exercise, dieting and ultimately weight loss can help obese patients manage their LBP 37 . Specifically, the reduction of the levels of systemic inflammation leads to a decrease of the inflammatory insult on neurons and improves pain thresholds and pain regulation, thus enabling better responses to mechanical strain or stimuli 37 .…”

Section: Low Back Pain and οBesitymentioning

confidence: 97%

“…Obesity, more narrowly, has been shown to relate LBP and general musculoskeletal pain 33,35,36 . Most of the studies however try to establish a link between obesity and low back pain instead of investigating the physiological causality 37 . According to hypotheses made in studies, the surplus adipose tissue in obese patients applies further mechanical pressure or increased shear on load bearing joints, like the lumbar spine structures 38 .…”

Section: Low Back Pain and οBesitymentioning

confidence: 99%

“…Last but not least, in the field of recovery from LBP in obese patients, bariatric surgery seems to show promising preliminary evidence of alleviation of LBP symptoms 37,40,42 . Furthermore, weight loss surgeries have been shown to help in the alleviation of the symptoms of or in the recovery from various comorbidities of obesity such as diabetes, hyperlipidemia, hypertension, gastroesophageal reflux disease (GERD), and nonalcoholic hepatic steatosis 41 .…”

Section: Low Back Pain and οBesitymentioning

confidence: 99%

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Positive correlation of different bariatric surgery techniques with low back pain

Galanis¹

2019

JRPMS

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A review of the existing literature on the issue of bariatric surgery and patients suffering from low back pain was carried out in various electronic databases (Medline/ PubMed, Google Scholar) with the use of the key words: low back pain, bariatric surgery, obesity, weight loss. Data reflecting encouraging a relation between low back pain, obesity and bariatric surgery were gathered from online publications, articles, studies, meta-analyses, prospective assessments and reviews internationally. The articles reviewed were from Abstract Low back pain is considered a universal and frequent health problem that is closely and causally associated with obesity, a modern era epidemic. The increased mechanical load placed on the spine, the systemic chronic inflammation or the metabolic syndrome are some of the causes of low back pain detected in obese patients that are directly linked to obesity. The aim of this article is to present a mini review of the existing literature regarding the relation between low back pain and different bariatric surgeries which have been shown to be valid methods of weight loss. Several studies in last decade have advocated that weight loss resulting from bariatric surgeries is associated with a lessening in impairment and intenseness of low back pain. The need for further systematic reviews and prospective trials is evident in order to support the claims that bariatric surgeries may prove beneficial to low back pain.

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“…Given these widely reported associations between lifestyle behavioural factors and low back pain, it is suggested that targeting these as part of low back pain management could improve patient outcomes [ 7 , 10 , 11 ]. While international guidelines for weight management recommend behavioural modification interventions as the preferred approach to managing weight loss and healthy lifestyle there is limited evidence to guide such care in patients with low back pain [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

A randomised controlled trial of a lifestyle behavioural intervention for patients with low back pain, who are overweight or obese: study protocol

Williams

Wiggers

O’Brien

et al. 2016

BMC Musculoskelet Disord

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BackgroundLow back pain is a highly prevalent condition with a significant global burden. Management of lifestyle factors such as overweight and obesity may improve low back pain patient outcomes. Currently there are no randomised controlled trials that have been conducted to assess the effectiveness of lifestyle behavioural interventions in managing low back pain. The aim of this trial is to determine if a telephone-based lifestyle behavioural intervention is effective in reducing pain intensity in overweight or obese patients with low back pain, compared to usual care.Methods/DesignA randomised controlled trial will be conducted with patients waiting for an outpatient consultation with an orthopaedic surgeon at a public tertiary referral hospital within New South Wales, Australia for chronic low back pain. Patients will be randomly allocated in a 1:1 ratio to receive a lifestyle behavioural intervention (intervention group) or continue with usual care (control group). After baseline data collection, patients in the intervention group will receive a clinical consultation followed by a 6-month telephone-based lifestyle behavioural intervention (10 individually tailored sessions over a 6-month period) and patients in the control group will continue with usual care. Participants will be followed for 26 weeks and asked to undertake three self-reported questionnaires at baseline (pre-randomisation), week 6 and 26 post randomisation to collect primary and secondary outcome data. The study requires a sample of 80 participants per group to detect a 1.5 point difference in pain intensity (primary outcome) 26 weeks post randomisation. The primary outcome, pain intensity, will be measured using a 0–10 numerical rating scale.DiscussionThe study will provide robust evidence regarding the effectiveness of a lifestyle behavioural intervention in reducing pain intensity in overweight or obese patients with low back pain and inform management of these patients.Trial registration numberAustralian New Zealand Clinical Trials Registry, ACTRN12615000478516, Registered 14/05/2015.

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Obesity and Low Back Pain: Is There a Weight of Evidence to Support a Positive Relationship?

Cited by 20 publications

References 98 publications

Association between serum lipids and low back pain among a middle-aged Japanese population: a large-scale cross-sectional study

Association between serum lipids and low back pain among a middle-aged Japanese population: a large-scale cross-sectional study

Positive correlation of different bariatric surgery techniques with low back pain

A randomised controlled trial of a lifestyle behavioural intervention for patients with low back pain, who are overweight or obese: study protocol

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