Doctors frequently warn us about the health risks of obesity. There’s a strong association linking cancer and heart disease with obesity. However, here’s something you might not have considered: obesity can significantly impact the health of your back.
Research shows a positive correlation between increased body mass index (BMI) and musculoskeletal pain, particularly in the lower back and lower limbs. Understanding this connection between back pain and obesity can provide valuable insights into both prevention and treatment options.
“Extra body weight puts additional stress on your bones and joints, including the spine,” said Dr. Rey Bosita, a spine surgeon with Texas Health Center for Diagnostics and Surgery. “This added stress can lead to injury and accelerate degeneration, contributing to chronic pain from conditions such as osteoarthritis.”
But it doesn’t stop there. Several other factors, including inflammation and lifestyle habits, also play a role in this complex relationship between obesity and back pain.
The Role of Inflammation
One lesser-known factor is the role of inflammation. Fat cells don’t just store energy; they also release chemicals that can cause inflammation. Studies have shown that obese individuals often exhibit higher levels of inflammatory markers, including interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), and C-reactive protein (CRP). These markers are closely linked to chronic inflammation, which not only exacerbates back pain but may also contribute to degenerative conditions in the spine.
Here’s how it works: as you gain weight, your fat cells produce and release more hormones and biochemicals that can trigger inflammation throughout your body. Inflammation could cause back pain by irritating nerves and tissues. Over time, inflammation, together with degeneration of discs and joints, accelerates the wear and tear on your spine. All that adds up to an increased risk of chronic back conditions like spinal stenosis and herniated discs.
Herniated Discs, Spinal Stenosis, Sciatica, and Obesity
Sciatica refers to pain along the path of the sciatic nerve, which extends from the buttocks and down each leg. Sciatica can be triggered by a herniated disc — also known as a slipped or ruptured disc — which puts pressure on the lumbar spine nerve roots, or it can be aggravated by spinal stenosis, which is another condition often associated with obesity. In either case, the spinal canal narrows, putting pressure on the nerves in your back. The result? Persistent lower back pain, sciatica, leg pain and symptoms like tingling, weakness, and numbness in the legs and buttocks. Usually, people with sciatica from spinal stenosis feel better when they lean forward, sit or lean on a support such as a shopping cart at the grocery store.
“For those living with spinal stenosis, losing weight can help alleviate symptoms by reducing the pressure on the spine and improving overall mobility,” said Dr. Bosita.
A Sedentary Lifestyle and the Pain Cycle
Another key factor linking obesity and back pain is lifestyle. A sedentary lifestyle is both a cause and a consequence of obesity and back pain. When you’re in pain, it’s natural to avoid movement. Unfortunately, inactivity can lead to weight gain, which further exacerbates pain. Plus, individuals who are struggling with depression or chronic pain may turn to overeating as a form of emotional relief. While this can provide temporary comfort, it ultimately leads to further weight gain and greater pain.
It’s a vicious cycle.
Weight Gain
Many people gain weight as they get older. Obesity rates tend to peak among people ages 40-59.1 Even if they are not obese, weight gain itself may contribute to lower back pain. Studies indicate that in adults over 50, weight gain significantly increases the risk of chronic lower back pain. The greater the weight gain, the higher the risk.
The Complexity of Obesity and Pain
Researchers emphasize that the relationship between obesity and pain is complex and multifactorial. It’s not simply a matter of “extra weight equals more pain.” For some, genetic predisposition can play a role in getting stuck in this destructive cycle. Others may face additional barriers, such as mental health challenges, that make addressing weight and pain more difficult.
Surgery is one treatment option for those with severe back pain that does not respond to less invasive treatments like pain medication and physical therapy.
“Surgeons may be reluctant to recommend surgery for obese patients because obesity is also associated with a greater risk of complications with spine surgery,” said Dr. Bosita. “In many cases, surgeons advise patients to lose weight before undergoing surgery.”
Weight Loss for Back Pain
The good news: Shedding even a small amount of weight can reduce the stress on your spine and joints, alleviate inflammation, and improve mobility. Here are some practical tips:
1. Start Moving: Low-impact exercises, like walking or swimming, can be a great way to ease into physical activity without putting too much strain on the back and joints. Exercise strengthens muscles, improves flexibility, and helps BURN calories.
2. Eat Smart: Eliminate snacks, sugar-laden soft drinks and candy. Substitute green leafy vegetables for starchy, low-fiber foods like rice, bread, potatoes and tortillas.
3. Watch Your Portions: Making small changes to your diet, such as eating smaller portions and choosing nutrient-dense foods, can help you lose weight gradually and sustainably.
4. Seek Support: If you’re struggling with pain or depression, consider working with a healthcare professional or counselor. They can help you address the underlying emotional challenges that may be contributing to overeating or inactivity.
5. Focus on Consistency: Sustainable changes often start small. Aim for consistency over perfection. A short daily walk or a few small dietary adjustments can add up to significant results over time.
6. Seek Accountability: Friends and family can be very helpful and encouraging, especially if they’re working on weight loss and health goals too. Make the journey fun. You do not have to do it alone.
A Word of Encouragement
If you’re experiencing back pain and wondering whether weight loss might help, know that you’re not alone. Many people face similar challenges, and while it may feel daunting, even modest steps can make a difference. With the right support and strategies, you can regain control of your health and well-being.
Ultimately, the connection between obesity and back pain underscores the importance of a holistic approach to health. By addressing weight, inflammation, and lifestyle habits, you can not only reduce your pain but also improve your overall quality of life.
And that’s something worth striving for.
Post reviewed by Dr. Rey Bosita, an orthopedic spine surgeon on the medical staff of Texas Health Center for Diagnostics and Surgery in Plano. Physicians on the medical staff are not employees of the hospital.
[1] https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity