Obesity and Lower Back Pain
by Dr. Michael Kia
Obesity is a growing public health concern, which has turned into a pandemic in Western society. Multiple health consequences usually associated with morbid obesity are high blood pressure, diabetes mellitus, hyperlipidemia, and sleep apnea. However, lower back pain (LBP) is probably the most common complaint among morbidly obese patients.
Morbid obesity is characterized by reduced range of motion of the spine, causing postural adaptation with an increased anterior pelvic tilt due to increased lumbar lordosis. In addition, obesity can increase the mechanical load on the spine by causing a higher compressive force or increased shear stress on the lumbar spine. Of note, osteoarthritis is estimated to affect 34% of the obese population and is significantly correlated with body mass index (BMI). Recently a major study was published that showed a significant benefit in LBP in patients who underwent bariatric surgery. By measuring the disc space between the vertebral bodies before and after surgery, researchers were able to find a clear association between significant weight loss and the resolution of lower back pain. While body weight decreased in the study group from a BMI of 42 to 28, the disc space increased from 6mm to 8mm. This result accurately also reflected the equivalent improvement in lower back pain.
These findings regarding lower back pain in patients with morbid obesity could help the millions of people who suffer with this condition. These findings add to the significant body of literature that shows the major benefits bariatric surgery offers to patients who suffer with the disease of morbid obesity and its plethora of co-morbid conditions.
Reference: Intervertebral Disc Height Changes After Weight Reduction in Morbidly Obese Patients and its Effect on Quality of Life and Radicular and Low Back Pain Lidar Z., et al. Spine. 2012;37(23):1947-1952.