Experiencing back pain often seems like a stroke of bad luck, striking unexpectedly after a day’s work in the garden or a night of inadequate sleep. However, recent studies indicate that weight may subtly influence the odds well before the pain manifests, incrementally increasing risk with each added pound.
A substantial investigation from Boston University’s Chobanian & Avedisian School of Medicine examined medical records of over 110,000 adult patients, revealing a distinct trend. As body weight escalated, the probability of experiencing low back pain also rose. For each additional unit of body mass index, roughly equivalent to 10 pounds beyond the ideal weight, there was a 7 percent increase in the occurrence of low back pain.
The results, published in Pain Medicine, are significant due to the extensive scope of the study. Earlier investigations linking weight and back pain often depended on smaller samples or specific patient demographics, like young men or those attending specialized clinics. In contrast, this analysis utilized data from routine outpatient visits at an urban teaching hospital, providing a wide, up-to-date view of adult patients over a one-year timeframe.
An Incremental Rise, Followed by a Plateau
Employing computerized assessments of electronic medical records, the research team probed into patients’ age, sex at birth, height, weight, BMI, and reported low back pain during their visits. The outcomes indicated a consistent rise in reported back pain as BMI increased from a healthy 18 to 35, traversing the spectrum from normal weight to obesity.
Within this range, the correlation was remarkably steady. Each incremental BMI increase corresponded with a 7 percent rise in low back pain prevalence. In practical terms, even minor weight increases accrued over time can steadily intensify strain on the lower back. For someone of average height, gaining a mere 10 pounds could significantly heighten the risk of experiencing back pain.
However, beyond a BMI of 35, the trend plateaued. The frequency of low back pain did not perpetually rise but remained relatively stable. The study did not delve into the reasons for this plateau, yet the authors highlight that the risk had already reached notable levels well before this point.
Low back pain ranks among the most prevalent reasons individuals seek medical attention, contributing to lost work, disability, and escalating healthcare expenses. Common risk factors encompass inadequate sleep, psychological and physical stress, lack of activity, smoking, and aging. While weight has long been considered a potential factor, evidence has been inconsistent, partly because numerous studies lacked the necessary scale to identify gradual, population-wide impacts.
An Alterable Aspect of the Equation
The authors emphasize that a higher weight does not inevitably lead to back pain. Numerous individuals with higher BMIs do not develop chronic issues, while many slender individuals do. Nonetheless, the evidence points toward weight as a significant and potentially adjustable factor in risk.
“Low back pain represents one of the most frequent complaints patients present to their healthcare providers. While medications, formal physical rehabilitation, and other treatments may assist, addressing risk factors can also alleviate LBP,” explains Michael D. Perloff, MD, PhD.
Perloff, the lead author of the study and an assistant professor of neurology, points out that healthcare professionals already urge patients to tackle factors like smoking and physical debilitation. The new findings indicate that weight management should be included in that advisory list. Carrying excess weight seems to place additional load on the lower spine, elevating the likelihood that ordinary movements result in pain.
Due to the observational nature of the data derived from medical records, the study cannot definitively assert that weight gain directly results in low back pain. It also records reported pain during clinic visits, not gauging the severity or duration of symptoms. Nevertheless, the substantial size of the cohort strengthens the observed pattern.
For patients, the takeaway is not one of blame or simple solutions. Weight alteration is complex, influenced by biological, environmental, stress-related factors, and access to medical care. However, the study implies that even minor adjustments toward a healthier weight range may diminish the chances of developing one of the most frequent and debilitating pain conditions seen in adults. Managing weight might not eradicate back pain but could subtly lessen the risk, one pound at a time.
Pain Medicine: 10.1093/pm/pnaf178
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