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Chiropractic & Manual Therapies
Published in: Chiropractic & Manual Therapies 1/2005

Open Access 01-12-2005 | Research

Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question

Authors: Timothy A Mirtz, Leon Greene

Published in: Chiropractic & Manual Therapies | Issue 1/2005

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Abstract

Background

Obesity as a causal factor for low back pain has been controversial with no definitive answer to this date. The objective of this study was to determine whether obesity is associated with low back pain. In addition this paper aims to provide a step-by-step guide for chiropractors and osteopaths on how to ask and answer a clinical question using the literature.

Methods

A literature review using the MEDLINE search engine using the keywords "obesity", "low back pain", "body mass index" "BMI" and "osteoarthritis" from years 1990 to 2004 was utilised. The method employed is similar to that utilised by evidence-based practice advocates.

Results

The available data at this time is controversial with no clear-cut evidence connecting low back pain with obesity.

Conclusion

There is a lack of a clear dose-response relationship between body mass index (BMI) and low back pain. Further, studies on the relationship between obesity and related lumbar osteoarthritis, knee pain, and disc herniation are also problematic.There is little doubt that future studies with controlled variables are needed to determine the existence of an unambiguous link, if any.
Literature
1.
Coulston AM: Obesity as an epidemic: facing the challenge. J Am Diet Assoc. 1998, 98 (10 Suppl 2): S6-S8. 10.1016/S0002-8223(98)00703-2.CrossRefPubMed
2.
Zipfel S, Lowe B, Herzog W: Eating behavior, eating disorders, and obesity. Ther Umsch. 2000, 57: 504-510.CrossRefPubMed
3.
Lissner L, Steen SN, Brownell KD: Weight reduction diets and health promotion. Am J Prev Med. 1992, 8: 154-158.PubMed
4.
Bowerman S, Bellman M, Saltsman P, Garvey D, Pimstone K, Skootsky S, Wang HJ, Elashoff R, Heber D: Implementation of a primary care physician network obesity management program. Obes Res. 2001, 9 (Supplement 4L): 321S-325S.CrossRefPubMed
5.
Leijon M, Hensing G, Alexanderson K: Sickness absence due to musculoskeletal diagnoses: association with occupational gender segregation. Scand J Public Health. 2004, 32: 94-101. 10.1080/14034940310006195.CrossRefPubMed
6.
Skinner HB: Current Diagnosis & Treatment in Orthopedics. 2000, Lange Medical Books. New York
7.
Walker BF, Muller R, Grant WD: Low back pain in Australian adults: the economic burden. Asia Pac J Public Health. 2003, 15: 79-87.CrossRefPubMed
8.
Buckwalter JA, Goldberg VM, Woo SL: Musculoskeletal Soft Tissue Aging: Impact on Mobility. 1993, American Academy of Orthopedic Surgeons Symposium. Rosemont, IL
9.
Felson DT: Weight and osteoarthritis. Am J Clin Nutr. 1996, 63: 430-432.
10.
Bener A, Alwash R, Gaber T, Lovasz G: Obesity and low back pain. Coll Antropol. 2003, 27: 95-104.PubMed
11.
Han TS, Schouten JS, Lean MEJ, Seidell JC: The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord. 1997, 21: 600-607. 10.1038/sj.ijo.0800448.CrossRefPubMed
12.
Kostova V, Koleva M: Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors. J Neurol Sci. 2001, 192: 17-25. 10.1016/S0022-510X(01)00585-8.CrossRefPubMed
13.
Mortimer M, Wiktorin C, Pernol G, Svensson H, Vingard E, MUSIC-Norrtalje study group. Musculoskeletal Intervention Center: Sports activities, body weight and smoking in relation to low-back pain: a population-based case-referent study. Scand J Med Sci Sports. 2001, 11: 178-84.CrossRefPubMed
14.
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. 10.1381/096089203765887714.CrossRefPubMed
15.
Bayramoglu M, Akman MN, Kilinc S, Cetin N, Yavuz N, Ozker R: Isokinetic measurement of trunk muscle strength in women with chronic low-back pain. Am J Phys Med Rehabil. 2001, 80: 650-5. 10.1097/00002060-200109000-00004.CrossRefPubMed
16.
Tsuritani I, Honda R, Noborisaka Y, Ishida M, Ishizaki M, Yamada Y: Impact of obesity on musculoskeletal pain and difficulty of daily movements in Japanese middle-aged women. Maturitas. 2002, 42: 23-30. 10.1016/S0378-5122(02)00025-7.CrossRefPubMed
17.
18.
Magora A, Schwartz A: Relation between the low back pain syndrome and x-ray findings. I: Degenerative osteoarthritis. Scand J Rehabil Med. 1976, 8: 115-125.
19.
Barton JE, Haight RO, Marsland DW, Temple TE: Low back pain in the primary care setting. J Fam Pract. 1976, 3: 363-6.PubMed
20.
Hodge AM, Zimmet PZ: The epidemiology of obesity. Bail Clin Endocrin Metab. 1994, 8: 577-599. 10.1016/S0950-351X(05)80287-3.CrossRef
21.
Seidell JC, Flegal KM: Assessing obesity: classification and epidemiology. Brit Med Bull. 1997, 53: 238-252.CrossRefPubMed
22.
Bray GA: Overweight is risking fate: definition, classification, prevalence, and risks. Ann NY Acad Sci. 1987, 499: 14-28.CrossRefPubMed
23.
Riley RE: Popular weight loss diets. Health and exercise implications. Clin Sports Med. 1999, 18: 691-701.CrossRefPubMed
24.
Luoma K, Riihimaki H, Raininko R, Luukkonen R, Lamminen A, Viikari Juntura E: Lumbar disc degeneration in relation to occupation. Scand J Work Environ Health. 1998, 24: 358-366.CrossRefPubMed
25.
Leboeuf-Yde C: Body weight and low back pain. A systematic literature review of 56 journal articles reporting on 65 epidemiologic studies. Spine. 2000, 25: 226-37. 10.1097/00007632-200001150-00015.CrossRefPubMed
26.
Garzillo MJ, Garzillo TA: Does obesity cause low back pain?. J Manipulative Physiol Ther. 1994, 17: 601-4.PubMed
27.
Leboeuf-Yde C, Kyvik KO, Bruun NH: Low back pain and lifestyle. Part II – Obesity. Information from a population-based sample of 29,424 twin subjects. Spine. 1999, 24: 779-83. 10.1097/00007632-199904150-00009.CrossRefPubMed
28.
Popkess-Vawter S, Patzel B: Compounded problem: chronic low back pain and overweight in adult females. Orthop Nurs. 1992, 11: 31-5. 43CrossRefPubMed
29.
O'Niel TW, McCloskey EV, Kanis JA, Bhalla AK, Reeve J, Reid DM, Todd C, Woolf AD, Silman AJ: The distribution, determinants, and clinical correlates of vertebral osteophytosis: a population based survey. J Rheum. 1999, 26: 842-848.
30.
Biering-Strenson F, Hansen FR, Schroll M, Runeborg O: The relation of spinal x-ray to low back pain and physical activity among 60 year old men and women. Spine. 1985, 10: 445-451.CrossRef
31.
Lean ME, Han TS, Seidell JC: Impairment of health and quality of life using new US federal guidelines for the identification of obesity. Arch Intern Med. 1999, 159: 837-43. 10.1001/archinte.159.8.837.CrossRefPubMed
32.
Riihimaki H, Wickstrom G, Hanninen K, Luoparjarvi T: Predictors of sciatic pain among concrete reinforcement workers and house painters: a five year follow-up. Scand J Work Environ Health. 1989, 15: 415-423.CrossRefPubMed
33.
Symmons DP, van Hermert AM, Vandenbroucke JP, Valkenburg HA: A longitudinal study of back pain and radiological changes in the lumbar spine of middle aged women I: clinical findings. Ann Rheum Dis. 1991, 50: 158-161.PubMedCentralCrossRefPubMed
34.
Kang SW, Lee WN, Moon JH, Chun SI: Correlation of spinal mobility with the severity of chronic lower back pain. Yonsie Med J. 1995, 36: 37-44.CrossRef
35.
Verbunt JA, Seelen HA, Vlaeyen JW, van de Heijden GJ, Heuts PH, Pons K, Knottnerus JA: Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain. 2003, 7: 9-21. 10.1016/S1090-3801(02)00071-X.CrossRefPubMed
36.
Bigos SJ, Chair : Acute Low Back Problems in Adults. Clinical Practice Guideline Number 14. 1995, Agency for Health Care Policy and Research
Metadata
Title
Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question
Authors
Timothy A Mirtz
Leon Greene
Publication date
01-12-2005
Publisher
BioMed Central
Published in
Chiropractic & Manual Therapies / Issue 1/2005
Electronic ISSN: 2045-709X
DOI
https://doi.org/10.1186/1746-1340-13-2

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