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24th January 2008

Obesity and Back Pain

By Philip Edwards

It wouldn’t be much of a jump to think that obesity causes back pain, but it’s just not true. Studies have shown that only the morbidly obese really suffer from weight related back problems. Just being overweight is not enough.

That does not mean that excess weight does not aggravate back problems – ones that almost everyone seems to suffer at one time or another – but it’s not a primary cause.

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among nearly one-third of Americans who are classified as obese. The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions.

That means only 30% - by no means all - and only those classified as obese (men with more than 25% body fat and women with more than 30% body fat).

The primary cause is related, however: poor physical condition due to lack of exercise. People who are overweight are also out of shape and this is the real culprit.

Back pain is definitely aggravated by obesity. People with extra weight in their stomachs cause the pelvis to pull forward and strains the lower back, creating lower back pain.

The back is amazingly strong and also very sensitive. Misalignment of the spine due to poor physical condition, spending all day seated and even sleeping in the wrong position provokes horrible and lasting pains.

Excess body weight does put pressure on the lumbar spine, joints and discs. But so does exercise, which only causes problems if done wrong.

Obesity does not seem to increase the incidence of back pain, but it does affect one's ability to respond to treatment.

So while obesity causes many serious health problems, back pain is normally not one of them.

The good news is that the cure for obesity is the same as for back pain – regular exercise!

Back pain can be a serious barrier to everyday living, much less exercising. Those who suffer chronic back pain find it difficult to exercise, that’s why it is important to involve your health care provider. Just doing random exercises may just make your condition worse, so it’s important to locate the cause of the problem before trying to use exercise to solve it.

There are some general guidelines you can follow to prevent back problems, however:

Keep strong abdominals – abs support the front of your body like the spine does the back and weak abs put more pressure on your spine, which suffers under a heavier load.

Keep flexible and mobile – avoid staying in the same position for long periods of time:
- Sleeping – try to maintain a fetal position with your knees up and change sides frequently. Avoid sleeping on your back or stomach for long periods.
- Seated – this position puts a lot of pressure on your back and hips which need to stay tense to maintain the body’s position. Get up and stretch frequently –avoid sitting for more than a few hours straight. Every two or three hours, try to get out and walk for 15 minutes or so to loosen up your legs.
Resistance Exercise:

Pay close attention to form, especially when bending over to lift heavier weights

Lift with your legs, not your back

Always work with a spotter when lifting heavy

Use a belt when doing dead lifts, squats and back exercises

Work up slow in small increments

Warm up first – never work your back cold

Cardio:

Avoid long duration high impact exercise until you get a good base (6 months +); this includes running

Change your cardio program to work different muscle groups every so often

Dance is a particularly effective – and fun – way to stay limber and flexible

Once you have a back problem, everything else seems to fade into insignificance –the pain takes over your world.

When this happens, don’t wait for it to go away or try to exercise through it – go to a qualified doctor and listen to him - pronto.

Despite all the horror stories of slipped disks, arthritis and herniated disks, these conditions are rare compared to the many treatable ills that plague the back. Sometimes the pain feels like you have a very serious condition indeed, but this is rarely the case.

Also note that depending on which type of doctor you see, the treatment modalities and even the diagnoses will be different. Not that one or the other is likely to more or less effective, but if you find that your chiropractor, for example, cannot seem to give you relief, go see an orthopedist.

Chiropractors have a faithful following for a good reason –they can bring instant relief to many back conditions without the use of drugs. On the down side, they often require you to make many visits to keep you “aligned”. For some, the relief from the pain is well worth the cost and time, but once the problem is solved, these frequent adjustments are questionable.

Orthopedic specialists, on the other hand, use muscle relaxers and injections to solve these problems – they don’t recommend surgery on the first visit. This is probably the biggest fear that prevents most people from consulting them from the beginning, but the doctor who specializes in these problems can often solve them in short order.

Don’t give up – if you continue to have pain, continue to seek solutions and control factors that might be aggravating your condition – but don’t expect it to go away.

More than a third of us suffer from some type of chronic musculoskeletal pain during our lives and it’s definitely a dark chapter, but ignoring it only makes it worse. Actively seek solutions and remember: an ounce of prevention is worth a pound of cure.