Can Being Overweight Cause Back Pain?

'The Truth Behind The Suggestion'

The Short Answer…

We all know that being overweight is not always the best choice for your overall health, but the question is can being overweight cause back pain?

The simple answer is Yes. Unfortunately, there is a very clear link between being overweight and experiencing back pain.

In actual fact, there are a number of spinal injuries/ conditions that are directly weight-related, all of which cause back pain.

Some can be reversed with weight loss, others not. In this article we not only answer the question around the effect of being overweight on back pain, but how to relieve that pain through weight loss.

Why being overweight can cause back pain…..

The effect of being overweight on your back pain is well documented as being directly related to back pain. This link is highlighted by the American Obesity Association in it’s factsheet on the ‘Health Effects Of Obesity’

To give you an idea of the prevalence of back pain in people with obesity, the same American Obesity Association put the figure at nearly one third of all Americans classified as ‘obese’ as also suffering with back pain.

To explain why, I’ll use a simple analogy. If I described your spine as being like lumps of bone (vertebrae), cushioned between jelly (the intervertebral discs), you might not be surprised that the ‘jelly’ can become squashed over time.

This ‘compression’ of your spine, can lead to a whole range of problems, but most commonly causes pressure on the nerves in your spinal cord resulting in back pain.

Indeed, compression of the spine is the central concept behind the treatment of inversion therapy (can inversion therapy help back pain?) and the invention of inversion tables and inversion chairs.

Being tipped upside down, then helps the spine to straighten, gaining it’s original length.

Being overweight, means the force (gravity + upper bodyweight) that is pushing down is substantially greater.

Similarly, bend over to pick something up and the weight you are lifting is the item plus your upper torso. The heavy the person, the heavier the total amount you are lifting.

Without any injury therefore, being overweight will naturally lead to the development of back pain quicker than in slim individuals.

Then there is the theory (not always agreed amongst academics), that being overweight alters your central point of gravity.

In other words, in a slim person the centre of gravity runs through their core, as our bodies are designed to handle.

If you have a large belly then your centre of balance is pulled forward and this pulling can result in your pelvis being pulled forward to support the extra weight. This can strain your lower back in particular and cause numerous back and spinal issues.

Another effect of this proposed altering of your centre of balance is a poor posture.

Again, the belly fat pulls your stance forward and causes an unnatural posture ‘compensating’ for the extra weight.

Then finally there is the impact of the excess fat just physically pulling or bouncing when you move, causing low level muscle strains in your back that can soon become very painful and debilitating.

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Can Being Overweight Cause Back Pain – The Statistics…

Being overweight can therefore act in a number of ways to distort/ hinder the natural performance of your spine.

While the logic behind the link may be obvious, there is also considerable real-life data too.

A 2017 study by the University of Tokyo Hospital in Japan reviewed the medical history of 1,152 men from 1986 to 2009. 

Not surprisingly, they found people of normal bodyweight to have the lowest incidence of back pain, followed by those classified as ‘overweight’, while those marked as ‘obese’ (the heaviest) had by far the highest risk.

Not only that, but they actually found a direct correspondence between a person’s BMI (body mass index) and the rate/ risk of back pain.

This backed up an earlier landmark review (2010) in the American Journal of Epidemiology that combined 95 good quality studies with 1000s of patients and came to the same conclusion. 

Can excess weight cause back pain? Absolutely yes.

Types Of Back Injury That Are More Likely If You Are Overweight…

Mechanical Strains

These are the most likely source of back pain for anyone – a general muscle strain that can happen at any time from overworking.

These are however, much more common if you are overweight because, not only is your centre of gravity distorted (pulling the spine out of it’s natural line), but your excess weight increases the pressure on it.

Osteoarthritis of the Spine

This is a breakdown of the cartilage in your joints. Logically, this will be greater if you are overweight, because of the increased pressure.

However, it’s not just your spine – overweight people often develop osteoarthritis in the hands much earlier and this is thought to be down to hampering the bodies ability to circulate blood and oxygen to all parts of the body.

Pinched Nerves

This occurs when your extra weight pushes itself into the spaces between the vertebrae in your lower back.

Lordosis

Lordosis or ‘swayback’ as it has been nicknamed, is when your spine develops an excessive curvature. A large belly of course helps to pull the spine forward and the result can be crippling back pain.

Compression Fracture

This is literally a broken back. The vertebrae (bones) in your back suffer fractures as a result of excessive strain being exerted on the bones.

Bulging Disc

A bulging disc occurs when your discs push our of their normal position, putting pressure on your spinal nerves.

Again this occurs most frequently in anyone suffering with obesity due to the increased strain on the spine.

Herniated Disc

A bit like a bulging disc, a herniated disc occurs when the inner core of your disc ruptures and bursts through the spinal column altogether.

Degenerative Disc Disease

In theory, degenerative disc disease occurs due to age. The discs start to break down as they become weak during the natural again process.

However, once again the excess strain of being overweight speeds up the process of aging , making DDD more common in increasingly young people with weight problems.

Osteoporosis

Excess weight and a sedentary lifestyle can cause a reduction in blood/ oxygen flow, followed by a reduction in bone density. This reduction in bone density can cause multiple fractures that are associated with back pain.

Will Losing Weight Correct My Back Pain?

This really all depends on how bad your back pain and what is now causing it.

If you started a gradual diet tomorrow, then over time your back pain is very likely to improve simply because there is less weight pushing down it.

That does not mean however, that the cause of your back pain has gone away. If the cause was a simple strain, then the reduced pressure will allow it to heal and it is indeed unlikely to come back.

If the cause was a herniated disc, then you may need surgery to correct the now underlying issue, although your general level of discomfort is likely to be lower.

Even if your excess weight has caused a degenerative disease that cannot be reversed, such as osteoporosis, then losing weight is still important because it will greatly help to slow the further development of the disease.

Can Extreme Weight Loss Actually Make Back Pain Worse?

It has been known for patients that undergo bariatric surgery and thus experience extreme weight loss, to actually suffer new back pain.

Indeed it is no uncommon for patients having had surgery to remove excess skin following extreme weight loss to still be suffering considerable back pain.

This is thought to be down to two reasons –

  • Your increased weight has altered your spinal alignment. Losing weight so quickly has not given your spine time to adjust back to the new ‘correct’ position, resulting in pain caused by this misalignment.
  • Your body fat may actually be cushioning your body against some impacts that could cause back pain.

I should quickly clarify this by pointing out that you are still much more likely to suffer back pain if you are overweight and risk starting damage that can never be repaired.

Losing weight is still infinitely better for back pain overall.

But in cases of EXTREME weight loss in short periods of time, there can still be some back pain caused.

Thankfully, much like a ‘smokers cough’ while giving up smoking, this pain is mostly likely to be short-term. In the long run, your back pain (however painful) will be significantly less if you slim than if you are overweight. 

The Final Word –

I was asked to answer the question of can being overweight cause back pain.

The obvious answer is yes it can, but hopefully I have shown the types of disorder and exactly why being overweight can cause these issues.

There is some dispute amongst academics about the level of influence of obesity on spondylosis (disk degeneration) as partly investigated by the Cornell University in 2017, but overall it is universally accepted the being overweight can cause back pain.

Of course not everyone who is overweight will get back pain, just as not everyone who is the perfect weight will never suffer with it.

It is therefore fair to say that being overweight does cause back pain. But to ensure that you don’t make it worse (at least in the short run), you need to lose weight gradually, allowing your body to adjust to it’s new size as you go.

Dramatic weight loss is likely to leave your spine misaligned again and cause further pain while it adjusts – albeit a sacrifice still well worth making for the long-term benefits.

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References –

1. Geraldine I. Pellecchia, MA, PT. (1994). Lumbar Traction: A Review of the Literature. Journal Of Orthopaedics and Sports Physical Therapy
2. Wegner I, Widyahening IS, van Tulder MW, Blomberg SEI, de Vet HCW, Brønfort G, Bouter LM, Heijden GJ. (Aug 2013). Traction for low-back pain. Cochrane Reviews.
3. Hyunju Oh, PhD, PT, SeokJoo Choi, Sangyong Lee, PhD, PT, Jioun Choi, PhD, PT, and Kwansub Lee, PhD, PT. (Nov 2018). The impact of manual spinal traction therapy on the pain and Oswestry disability index of patients with chronic back pain. The Journal Of Physical Therapy Science.
4. Yu-Hsuan Cheng, Chih-Yang Hsu, Yen-Nung Lin (Aug 2019). The effect of mechanical traction on low back pain in patients with herniated intervertebral disks: a systemic review and meta-analysis. Clinical Rehabilitation.

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