Back pain and obesity: links, causes and treatments

If you are obese, being overweight can put pressure on your spine or alter your posture, making back pain more likely.

Obesity is a common condition that affects approx 2 out of 5 adults in the United States. Obesity can contribute to several types of back pain, including lower back pain, sciatica, and disc degeneration.

Carrying excess weight puts stress on your spine, which can affect the discs between your vertebrae. Excess weight in the abdomen and breasts can also affect your posture. Poor posture often contributes to back pain.

In this article, we provide information about the link between obesity and back pain. We also discuss treatments and strategies you can use to relieve discomfort.

Not every obese person will experience back pain, but these conditions often coincide. Obesity can be a primary cause of back pain, but it can also exacerbate an existing condition.

A large study published in 2017 found that obesity and overweight are associated with lower back pain and degenerative disc disease. The researchers found that obesity can be used as a predictor of future lower back problems, but the researchers were unable to prove that obesity directly causes back pain.

There are a number of theories about why obese people are more likely to have back pain. These theories include:

  • Changed attitude: Having too much weight around your waist can change your posture. Your pelvis and lower back can tilt forward, altering the natural curvature of your spine. This change can put undue pressure on the intervertebral discs and spinal nerves, causing conditions such as:
    • spinal compression
    • disk degeneration
    • pinched nerves
  • Disk Compression: Being overweight can increase the pressure on the joints in your spine (vertebra). Over time, pressure on these joints can cause the soft discs between your spinal bones to thin or bulge, leading to chronic pain and pinched nerves.
  • Ignition: Obesity is linked to chronic, low-grade inflammation. Inflammation throughout the body can increase your risk for chronic pain conditions.

Your back is made up of four regions, from top to bottom:

  • cervical spine (neck region)
  • thoracic spine (upper and mid back)
  • lumbar spine (lower back)
  • sacrum and coccyx (posterior pelvic wall and tailbone)

Anyone can get back pain in any of the four regions. If you are obese, you are more likely to have back pain in your lower back.

Lower back pain

Many conditions and injuries can lead to lower back pain. Even a bad night’s sleep can cause temporary lower back pain. Chronic and severe low back pain usually have more serious underlying causes, such as spinal compression, sciatica, and joint inflammation.

If you have obesity, lower back pain can result in areas such as:

  • joints
  • nerves
  • intervertebral discs
  • ligaments
  • tendons
  • muscles
  • vertebrae

Carrying excess weight in your stomach can eventually make your spine arch and arch. This change can put further pressure on your sacrum and the sacroiliac joints at the bottom of your spine.

Disk related issues

Between the vertebrae are the intervertebral discs of the back. When you walk or run, your intervertebral discs cushion your vertebrae, acting as shock absorbers. These discs also help your spine with flexibility, allowing you to bend and twist.

If you are obese, the excess weight can put more pressure on the intervertebral discs than they can handle. Increased pressure on the discs can lead to disc degeneration, where the discs become thinner over time, or disc injuries such as a herniated disc.

A herniated disc occurs when the jelly-like substance in a disc pushes through the outer lining and puts pressure on the nerve roots that branch out from your spinal cord. Sciatica is a condition that occurs when one of the discs in your lower back pushes (or pinches) a nerve that runs to your leg.

Obesity can contribute to the long-term progressive weakening of one or more discs (degenerative disc disease).

Degenerative changes

Degenerative changes to the spine are caused by long-term gradual changes in the structure and functionality of your spine. Aging is the leading cause of degenerative changes to the spine.

Another cause of spinal degenerative changes is osteoarthritis. Being overweight puts pressure on joints, which can exacerbate arthritis in the back and other parts of the body, such as knees. Fat cells also secrete inflammation-causing chemicals, which can make arthritis pain worse.

Losing weight can relieve inflammation and reduce pressure on your spine, which can reduce pain.

If exercise is part of your weight loss plan, you can also strengthen your abdominal and back muscles. Strengthening these areas provides better spinal support and is beneficial for pain relief.

Obesity is difficult to treat with diet and exercise alone. Even if you lose a significant amount of weight on your own, the effects are often temporary.

Talk to a healthcare provider about your weight loss goals. Obesity is a treatable medical condition.

Treatments can include:

  • weight loss surgery
  • weight loss medications
  • therapy or coaching programs
  • medically supervised diet and exercise programs

Weight loss medications

There are several weight management medications on the market and more are on the way. Many people have had success with glucagon-like peptide-1 (GLP-1) agonists. Semaglutide (Wegovy) is a Food and Drug Administration (FDA)-approved treatment for obesity.

The same drug, marketed as Ozempic, is FDA-approved to treat type 2 diabetes, but it has the same weight loss effects.

According to one study, semaglutide injections once a week help people lose an average of 15% of their body weight in less than a year and a half.

Weight loss medications work by reducing your appetite and making you feel full faster. They also help with insulin resistance.

Talk to a healthcare provider about your options.

Physical therapy can greatly help reduce back pain.

Physical therapists use strategies such as manual therapy, massage, and electrical stimulation to relieve inflammation, loosen muscles, and reduce back pain.

A physical therapist will also guide you through exercises that strengthen the back and abdomen and support flexibility. These activities can include strength training with props such as body bands and low-impact aerobic activities such as cycling on a stationary bike.

Good posture while sitting and standing helps promote proper spinal alignment and can reduce back pain. The way you hold your body when you lift, bend, and perform other movements also has an effect.

Being aware of your posture takes work. If you find yourself slouching, try sitting or standing up straight. It may help to keep your shoulder blades tucked in and tighten your core (abdominal muscles).

The use of ergonomic aids, such as posture-correcting seat cushions, can also help. These devices work by keeping your body properly aligned without you having to focus on it.

Obesity can contribute to back pain and make existing conditions worse. Carrying excess weight can put unnecessary pressure on your spine. Being overweight can also increase inflammation.

Losing weight and exercising can be beneficial for reducing back pain. If you are obese, you may want to talk to a healthcare provider about your options.

Back pain and obesity: links, causes and treatments

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