Ergonomy (N Teasdale, Section Editor)

Current Obesity Reports

, Volume 2, Issue 3, pp 241-250

First online:

Obesity and Low Back Pain: Is There a Weight of Evidence to Support a Positive Relationship?

  • Darren M. RoffeyAffiliated withClinical Epidemiology Program, Ottawa Hospital Research InstituteThe Ottawa Hospital, University of Ottawa Spine Program
  • , Adele BudianskyAffiliated withThe Ottawa Hospital, University of Ottawa Spine ProgramDepartment of Medicine, Faculty of Health Sciences, McMaster University
  • , Matthew J. CoyleAffiliated withFaculty of Medicine, University of OttawaThe Ottawa Hospital, University of Ottawa Spine Program
  • , Eugene K. WaiAffiliated withClinical Epidemiology Program, Ottawa Hospital Research InstituteThe Ottawa Hospital, University of Ottawa Spine ProgramDivision of Orthopaedic Surgery, Department of Surgery, University of Ottawa Email author 

Abstract

Obesity and low back pain (LBP) are responsible for significant morbidities and financial expenditure. Numerous studies have demonstrated a positive relationship between obesity and LBP, but a concurrent investigation of causality is often omitted. Spinal clinicians routinely prescribe exercise and weight loss for obese patients with LBP, despite a paucity of literature evaluating why obesity might cause LBP or how exercise and weight loss might be suitable treatments for LBP. Etiologies have tended to focus on the biomechanical effects of obesity that lead to excessive loading and degeneration of the lumbar spine. However, recent evidence suggests that systemic inflammation associated with obesity may also be an important contributor to LBP. In this article, the latest evidence investigating the relationship between obesity and LBP is reviewed, an overview of the impact of exercise and weight loss on LBP is provided, and proposed mechanisms connecting obesity, systemic inflammation, and LBP are outlined.

Keywords

Obesity Low back pain Exercise Weight loss Lifestyle modification Bariatric surgery Non-surgical Health care utilization Body mass index Inflammation C-reactive protein Vitamin C Morbidity Etiology