Study of One Million Americans Shows Obesity and Pain Linked

A clear association between obesity and pain - with higher rates of pain identified in the heaviest individuals - was found in a study of more than one million Americans published January 19 in the online edition of Obesity. In “Obesity and Pain Are Associated in the United States,” Stony Brook University researchers Arthur A. Stone, PhD., and Joan E. Broderick, Ph.D. report this finding based on their analysis of 1,010,762 respondents surveyed via telephone interview by the Gallop Organization between 2008 and 2010.

Previous small-scale studies have shown links between obesity and pain. The Stony Brook study took a very large sample of American men and women who answered health survey questions. The researchers calculated respondents’ body mass index (BMI) based on questions regarding height and weight. Respondents answered questions about pain, including if they “experienced pain yesterday.”

“Our findings confirm and extend earlier studies about the link between obesity and pain. These findings hold true after we accounted for several common pain conditions and across gender and age,” says Dr. Stone, Distinguished Professor and Vice Chair, Department of Psychiatry and Behavioral Science, Stony Brook University School of Medicine, and an expert on patient reported measures of health, pain, and well-being.

Sixty three percent of the 1,010,762 people who responded to the survey were classified as overweight (38 percent) or obese (25 percent). Obese respondents were further classified into one of three obesity levels as defined by the World Health Organization. In comparison to individuals with low to normal weight, the overweight group reported 20 percent higher rates of pain. The percent increase of reported pain in comparison to the normal weight group grew rapidly in the obese groups: 68 percent higher for Obese 1 group, 136 percent higher for Obese 2 group, and 254 percent higher for Obese 3 group.

“We wanted to explore this relationship further by checking to see if it was due to painful diseases that cause reduced activity, which in turn causes increased weight,” says Joan E. Broderick, Ph.D., Associate Professor in the Department of Psychiatry and Behavioral Science and School of Public Health at Stony Brook University, and lead investigator of a National Institutes of Health-funded study on how arthritis patients manage their own pain.

If you are overweight or obese, you may be grappling with back pain, a very common problem for heavy people. Carrying extra weight can increase your risk for developing several back disorders.

Pressure on the Spine
Extra weight puts added pressure on the spine, which can cause pain, says Kevin Cichocki, DC, clinical chiropractor and founder of Palladian Health. “It has long been known that a rise in body weight results in a geometric increase in the pressure on the spine.” For those who are morbidly obese, Cichocki adds that the injury to the spine is even greater. This is due to degenerative changes in the vertebral column, he says. The pressure may increase your risk of herniated disk, degenerative disk disease and back strain.

Will Losing Weight Reduce My Back Pain?
It’s only common sense to think that along with controlling your risk for heart attack, diabetes, stroke and other degenerative diseases, losing weight can help you get rid of back pain. While there’s not a lot of research to address this question, the little that is there may confirm what you were thinking. Dr. Andre Panagos, physiatrist and co-director of the Spine Center at New York Presbyterian Hospital says, “in my office, every single person who loses a significant amount of weight finds that their back pain is also significantly improved”. Panagos believes the reason for this is related to a decrease in the amount of work muscles need to do in order to accomplish everyday tasks, once weight loss has been achieved. Let this tip from a doctor fuel your motivation as you as continue your efforts to reach and maintain a healthy weight!

“We found that ‘pain yesterday’ was definitely more common among people with diseases that cause bodily pain. Even so, when we controlled for these specific diseases, the weight-pain relationship held up. This finding suggests that obesity alone may cause pain, aside from the presence of painful diseases,” Dr. Broderick explains.

Interestingly, the pain that obese individuals reported was not driven exclusively by musculoskeletal pain, a type of pain that individuals carrying excess weight might typically experience.

Obesity, height linked to pain in lower back
“The most simple explanation for that correlation is that the mechanical load of overweight and body height (on the lever arm) may cause early failure of the back-supporting mechanism and cause early (low back pain) complaints,” said lead author Oded Hershkovich, an orthopedic surgeon in Israel.

The study, which was presented Friday at a national meeting of spine surgeons, involved 17-year-old male and female Israeli military recruits who had undergone medical exams before service induction between 1998 and 2009.

The risk of low back pain was relatively low in both male and female recruits. Obese males were 16 percent more likely to have low back pain; for females it was 21 percent.

Height also increased risk. The tallest males (average height, 6 feet) were 44 percent more likely to have low back pain, compared with the shortest males (average height, 5 feet 5 inches). Tall females (average height, 5 feet 7 inches) were 22 percent more likely to have back pain than the shortest females (average height, 5 feet 1 inch).

Distributed by MCT Information Services

Drs. Broderick and Stone also suggest that there could be several plausible explanations for the close obesity/pain relationship. These include the possibility that having excess fat in the body triggers complex physiological processes that result in inflammation and pain; depression, often experienced by obese individuals, is also linked to pain; and medical conditions that cause pain, such as arthritis, might result in reduced levels of exercise thereby resulting in weight gain. The researchers also indicated that the study showed as people get older, excess weight is associated with even more pain, which suggests a developmental process.

Drs. Broderick and Stone believe that the study findings support the importance of metabolic investigations into the causes of pain, as well as the need for further investigation of the obesity - pain link in U.S. populations.


Source: Stony Brook University Medical Center

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