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SIZE MATTERS!! … LOW BACK PAIN & OBESITY

May 8, 2023

Low back pain is an established worldwide problem. At Integrity Chiropractic, we deal with this debilitating issue on a daily basis. It’s estimated that approximately 80% of the North American population will experience significant low back pain at some point in their adult lives. Word wide estimates range between 50–80% of adults experiencing low back pain in their life. (1,2,3) in fact, low back pain (LBP) is the second most common cause of disability in US adults with an estimated 149 million days of work lost per year. (4) It is no surprise that people are increasingly seeking chiropractic care to find relief.

The link between low back pain incidence and obesity is alarming. According to the National Institute of Health (NIH) and the Centers for Disease control, CDC, the prevalence of being overweight was 70.2 % in 2013-2104 using NHANES data. Just the obesity portion of that number was 42.4% in 2017-2018. (5,6) Evidence confirms that obesity seriously impacts the spine and musculoskeletal system, increasing the risk of low back pain as well as osteoarthritis, spondylolisthesis, degenerative disc disease and spinal stenosis. (7) Studies have even shown that people who underwent surgery to help them lose weight experienced less low back pain, the link is genuine. (8, 9)

Cause and Effect: Obesity can drive Low Back Pain

Some authors suggest that the link between obesity and low back pain is inconclusive, (10) yet there are obvious reasons why an obese person would experience more low back pain.

First, let us look at the most common cause. Obesity in the United States is primarily related to poor nutrition and lack of exercise. Our meals are often high in refined carbohydrates and low in essential fatty acids and proper nutrients. This leads us to Pro-inflammatory states and inflammation causes pain. Consuming large amounts of sugary caffeinated beverages also robs the skeleton of calcium which can weaken weight bearing over time. (11)

Second, as a person packs on more fat, mobility becomes difficult. Therefore, many obese people choose to remain inactive, preceding joint problems. Sedentary lifestyle leads to spinal immobility and overload, both have which been shown to damage the disc and the joints of the low back. (12) Lack of movement in the joints can accelerate degenerative changes as seen in cases of osteoarthritis. If an obese person does remain active, the extra body weight creates surplus compressive stress and shear strain on the muscles, tendons, ligaments and joints.

Third, postural changes are common in obese people, caused by extra weight in the abdomen. As the size of the mid-section increases, the spine’s center of gravity shifts forward and the lower back curve is exaggerated (hyper-lordosis) to accommodate for these changes. (13) This even happens in children. (14) Hyper-lordosis increases compressive loads on the joints of the lower back, increasing subluxation and pain.

What Can You Do About Weight Problems?

When faced with weight issues, the first thing you should do is consult a healthcare professional with advanced training in weight loss. At Integrity Weight Loss, Dr. Sarah Leatherman has completed her 300 hour post-doctoral Chiropractic Internist program. (15,16) Dr. Sarah order’s blood tests, genetic tests, GI maps, and urinalysis when indicated to determine metabolic, hormone or GI disorders. The information aids in maintaining proper weight and body fat reductions. Dr. Sarah is also extremely knowledgeable in proper nutrition, portion control and meal planning. Eating because your body requires proper fuel is different than eating for comfort or pleasure. However, you can have delicious meals that are also health conscious, increase metabolism, reduce fat deposition and reduce chronic disease states. Your body is a high performance machine, proper fuel will keep it running smoothly.

Before starting an exercise program, also check with your doctor of chiropractic. Weeks, months or years of inactivity can leave your body too weak to pick up where you left off. Attempting to build strength on poor underlying spinal structure only drives more dysfunction. Dr. Leatherman and Dr. Bak frequently have to modify patient exercise programs for success. This gives you the best chance for continued progress as your exercise routine varies.

Above all else, value your health and stay positive, we have the tools to help. Dr. Shawn Leatherman and Dr. David Bak have successfully treated thousands of low back pain cases here at Integrity Chiropractic. Dr. Sarah Leatherman has helped patients drop thousands of unwanted pounds of fat at Integrity Weight Loss. Read about people who have achieved weight loss and/or pain reduction, and reach out to us for help.

References and Sources:

1. Rubin DI (2007) Epidemiology and risk factors for spine pain. Neurol Clin 25(2):353–371 https://www.ncbi.nlm.nih.gov/pubmed/17445733

2. Skinner HB. Current Diagnosis & Treatment in Orthopedics. Lange Medical Books. New York; 2000.

3. Volinn E (1997) The epidemiology of low back pain in the rest of the world: a review of surveys in low-and middle-income countries. Spine 22(15):1747–1754 https://www.ncbi.nlm.nih.gov/pubmed/9259786

4. From the Centers for Disease Control and Prevention. Prevalence of disabilities and associated health conditions among adults--United States, 1999. JAMA. 2001;285(12):1571–1572.

https://www.ncbi.nlm.nih.gov/pubmed/11302137

5. https://www.niddk.nih.gov/health-information/health-statistics/overweight-obesity

6. https://www.cdc.gov/obesity/data/adult.html

7. Silveri CP & Spinasanta S. Back pain and obesity: connection to back pain and the development of obesity. Montclair, NJ: SpineUniverse; ©1999-2011. http://www.spineuniverse.com/conditions/back-pain/back-pain-obesity.

8. Melissas J, Volakakis E, Hadjipavlou A. Low back pain in morbidly obese patients and the effect of weight loss following surgery. Obes Surg. 2003;13:389–393. https://www.ncbi.nlm.nih.gov/pubmed/12841899

9. Melissas, J., Kontakis, G., Volakakis, E. et al. The Effect of Surgical Weight Reduction on Functional Status in Morbidly Obese Patients with Low Back Pain. OBES SURG 15, 378–381 (2005). https://link.springer.com/article/10.1381/0960892053576703#citeas

10. Mirtz TA & Greene L. Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropractic & Osteopathy 2005; 13(2). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1151650/

11. Hernandez-Avila M, Stampfer MJ, Ravnikar VA, Willett WC, Schiff I, Francis M, Longcope C, McKinlay SM. Caffeine and other predictors of bone density among pre-and peri-menopausal women. Epidemiology 1993 Mar; 4(2): 128-34. https://www.ncbi.nlm.nih.gov/pubmed/8452901

12. Ian A. F. Stokes, PhD, and James C. Iatridis, PhD Mechanical Conditions That Accelerate Intervertebral Disc Degeneration: Overload Versus Immobilization. SPINE Volume 29, Number 23, pp 2724–2732. https://www.ncbi.nlm.nih.gov/pubmed/15564921

13. Mi-Yeon Song, Won-Suk Chung, Sung-Soo Kim, Hyun-Dae Shin. Correlation between Obesity and Lumbar Lordosis in Obese PreMenopausal Korean Females 2004. Vol. 25. No. 4. 43-50

Korean Journal of Oriental Medicine https://www.jkom.org/upload/06-Correlation%20between%20Obesity(105431).PDF

14. Jankowicz-Szymańska A1, Bibro M1, Wodka K1, Smola E1. Does Excessive Body Weight Change the Shape of the Spine in Children? Child Obes. 2019 Jul;15(5):346-352. doi: 10.1089/chi.2018.0361. Epub 2019 Apr 12. https://www.ncbi.nlm.nih.gov/pubmed/30977672

15. http://www.floridadabci.com/

16. https://www.dabci.info/

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