The burden of low back pain in children and adolescents with overweight and obesity: from pathophysiology to prevention and treatment strategies

Abstract

Nonspecific low back pain (LBP) is one of the most common causes of disability, affecting all individuals at least once in their lifetime. Such a condition is also becoming increasingly frequent in the pediatric population, especially in children and adolescents with overweight/obesity. Furthermore, new-onset LBP during adolescence has been demonstrated to be a strong predictor of developing LBP later in life, contributing to poorer outcomes and increasing social and medical costs. Several causes and different mechanisms have been considered for the development of LBP in pediatric individuals affected by obesity. For this reason, planning adequate prevention and treatment strategies, mainly through conservative lifestyle changes, would be crucial to anticipate the negative consequences of persisting LBP in adulthood. The aim of this narrative review was to characterize the relationship between LBP and overweight/obesity in the pediatric population, highlighting epidemiological and pathophysiological aspects. In addition, prevention and treatment approaches will be reviewed considering the need to reduce the burden of LBP on this population. According to our search, LBP was more frequent in children and adolescents with overweight and obesity and has been associated with several anthropometric and lifestyle factors, including lumbar hyperlordosis, sedentary habits, physical inactivity, carrying a heavy schoolbag, low vitamin D levels, psychosocial ill-being, and premature intervertebral disc degeneration. Most of these conditions may be addressed with conservative strategies mainly consisting of dietary adjustments, physical exercise, education programs, and physical therapy.

Roles of organokines in intervertebral disc homeostasis and degeneration

“…Current evidence suggests that the release and interactions of organokines could be regulated by multiple factors, making their impact challenging to quantify. Lifestyle factors such as exercise, diet, stress, sleep, and microbiome profoundly influence organokines production, affecting disc homeostasis and susceptibility to IVDD-related diseases (6,(164)(165)(166). Exercise, known as beneficial for IVD homeostasis, can modulate the release and activity of organ factors like irisin, ANGPTL4, osteocalcin, and adiponectin (113,167).…”

Conditioned Medium of Intervertebral Disc Cells Inhibits Osteo-Genesis on Autologous Bone-Marrow-Derived Mesenchymal Stromal Cells and Osteoblasts

“…Low back pain (LBP), a significant global health issue and complex condition, arises from a multifaceted interplay of factors [1]. Reverberating across societies worldwide, the challenges posed by LBP are profound: reduced quality of life, impaired mobility, and substantial healthcare costs [2]. The frequent cause is intervertebral disc (IVD) degeneration [3,4].…”

Efectos de un programa de actividad física de corrección postural y activación muscular para la pre-vención del dolor lumbar en alumnado de Educación Física de 5º y 6º de Educación Secundaria Obligatoria (Effects of a physical activity program of postural correction and muscle activation for the prevention of low back pain in Physical Education students in 5th and 6th grade of Compulsory Secondary Education)

“…Las causas son muy diversas, aunque en adolescentes uno de los elementos relacionados más importantes son el sobrepeso y la obesidad (Ambrosio et al, 2023), claramente vinculados a una mayor prevalencia, además de a aspectos antropométricos y a un estilo de vida sedentario (Mutlu et al, 2023). Por tanto, no tienen por qué deberse obligatoriamente a patologías estructurales, pueden originarse en hábitos posturales incorrectos y sobreesfuerzos (Castillo, 2000) y como indica García (2019) ocurre incluso en deportistas, quienes, a pesar de obtener en su mayoría valores normales en pruebas de alineación raquídea, presentan desviaciones lumbares o torácicas en aproximadamente un 20% de los casos.…”