Skip to main content
Top
Published in: BMC Public Health 1/2016

Open Access 01-12-2016 | Research article

Relative abdominal adiposity is associated with chronic low back pain: a preliminary explorative study

Authors: Cristy Brooks, Jason C. Siegler, Paul W. M. Marshall

Published in: BMC Public Health | Issue 1/2016

Login to get access

Abstract

Background

Although previous research suggests a relationship between chronic low back pain (cLBP) and adiposity, this relationship is poorly understood. No research has explored the relationship between abdominal-specific subcutaneous and visceral adiposity with pain and disability in cLBP individuals. The aim of this study therefore was to examine the relationship of regional and total body adiposity to pain and disability in cLBP individuals.

Methods

A preliminary explorative study design of seventy (n = 70) adult men and women with cLBP was employed. Anthropometric and adiposity measures were collected, including body mass index, waist-to-hip ratio, total body adiposity and specific ultrasound-based abdominal adiposity measurements. Self-reported pain and disability were measured using a Visual Analogue Scale (VAS) and the Oswestry Disability Index (ODI) questionnaires respectively. Relationships between anthropometric and adiposity measures with pain and disability were assessed using correlation and regression analyses.

Results

Significant correlations between abdominal to lumbar adiposity ratio (A-L) variables and the waist-to-hip ratio with self-reported pain were observed. A-L variables were found to predict pain, with 9.1–30.5 % of the variance in pain across the three analysis models explained by these variables. No relationships between anthropometric or adiposity variables to self-reported disability were identified.

Conclusions

The findings of this study indicated that regional distribution of adiposity via the A-L is associated with cLBP, providing a rationale for future research on adiposity and cLBP.
Literature
1.
go back to reference 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 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
2.
3.
go back to reference Bener A, Alwash R, Gaber T, et al. Obesity and low back pain. Coll Antropol. 2003;27:95–104.PubMed Bener A, Alwash R, Gaber T, et al. Obesity and low back pain. Coll Antropol. 2003;27:95–104.PubMed
4.
go back to reference Deyo RA, Bass JE. Lifestyle and low-back pain. The influence of smoking and obesity. Spine. 1989;14:501–6.CrossRefPubMed Deyo RA, Bass JE. Lifestyle and low-back pain. The influence of smoking and obesity. Spine. 1989;14:501–6.CrossRefPubMed
5.
go back to reference Han TS, Schouten JS, Lean ME, et al. The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord. 1997;21:600–7.CrossRefPubMed Han TS, Schouten JS, Lean ME, et al. The prevalence of low back pain and associations with body fatness, fat distribution and height. Int J Obes Relat Metab Disord. 1997;21:600–7.CrossRefPubMed
6.
go back to reference Heuch I, Hagen K, Nygaard O, et al. The impact of body mass index on the prevalence of low back pain: the HUNT study. Spine. 2010;35:764–8.CrossRefPubMed Heuch I, Hagen K, Nygaard O, et al. The impact of body mass index on the prevalence of low back pain: the HUNT study. Spine. 2010;35:764–8.CrossRefPubMed
7.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
8.
go back to reference 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. discussion 783–774.CrossRefPubMed 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. discussion 783–774.CrossRefPubMed
9.
go back to reference Mirtz TA, Greene L. Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropr Osteopat. 2005;13:2. Mirtz TA, Greene L. Is obesity a risk factor for low back pain? An example of using the evidence to answer a clinical question. Chiropr Osteopat. 2005;13:2.
10.
go back to reference Nilsen TI, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trondelag Health Study. Am J Epidemiol. 2011;174:267–73.CrossRefPubMed Nilsen TI, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trondelag Health Study. Am J Epidemiol. 2011;174:267–73.CrossRefPubMed
11.
go back to reference Shiri R, Solovieva S, Husgafvel-Pursiainen K, et al. The association between obesity and the prevalence of low back pain in young adults: The Cardiovascular Risk in Young Finns Study. Am J Epidemiol. 2008;167:1110–9.CrossRefPubMed Shiri R, Solovieva S, Husgafvel-Pursiainen K, et al. The association between obesity and the prevalence of low back pain in young adults: The Cardiovascular Risk in Young Finns Study. Am J Epidemiol. 2008;167:1110–9.CrossRefPubMed
12.
go back to reference Urquhart DM, Berry P, Wluka AE, et al. 2011 Young Investigator Award winner: Increased fat mass is associated with high levels of low back pain intensity and disability. Spine. 2011;36:1320–5.CrossRefPubMed Urquhart DM, Berry P, Wluka AE, et al. 2011 Young Investigator Award winner: Increased fat mass is associated with high levels of low back pain intensity and disability. Spine. 2011;36:1320–5.CrossRefPubMed
13.
14.
go back to reference Mangwani J, Giles C, Mullins M, et al. Obesity and recovery from low back pain: a prospective study to investigate the effect of body mass index on recovery from low back pain. Ann R Coll Surg Engl. 2010;92:23–6.CrossRefPubMedPubMedCentral Mangwani J, Giles C, Mullins M, et al. Obesity and recovery from low back pain: a prospective study to investigate the effect of body mass index on recovery from low back pain. Ann R Coll Surg Engl. 2010;92:23–6.CrossRefPubMedPubMedCentral
15.
go back to reference WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1–253 WHO. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i-xii, 1–253
16.
go back to reference Bazzocchi A, Filonzi G, Ponti F, et al. Accuracy, reproducibility and repeatability of ultrasonography in the assessment of abdominal adiposity. Acad Radiol. 2011;18:1133–43.CrossRefPubMed Bazzocchi A, Filonzi G, Ponti F, et al. Accuracy, reproducibility and repeatability of ultrasonography in the assessment of abdominal adiposity. Acad Radiol. 2011;18:1133–43.CrossRefPubMed
17.
go back to reference De Lucia RE, Sleigh A, Finucane FM, et al. Ultrasound measurements of visceral and subcutaneous abdominal thickness to predict abdominal adiposity among older men and women. Obesity. 2010;18:625–31.CrossRef De Lucia RE, Sleigh A, Finucane FM, et al. Ultrasound measurements of visceral and subcutaneous abdominal thickness to predict abdominal adiposity among older men and women. Obesity. 2010;18:625–31.CrossRef
18.
go back to reference Eston R, Evans R, Fu F. Estimation of body composition in Chinese and British men by ultrasonographic assessment of segmental adipose tissue volume. Br J Sports Med. 1994;28:9–13.CrossRefPubMedPubMedCentral Eston R, Evans R, Fu F. Estimation of body composition in Chinese and British men by ultrasonographic assessment of segmental adipose tissue volume. Br J Sports Med. 1994;28:9–13.CrossRefPubMedPubMedCentral
19.
go back to reference Fanelli MT, Kuczmarski RJ. Ultrasound as an approach to assessing body composition. Am J Clin Nutr. 1984;39:703–9.PubMed Fanelli MT, Kuczmarski RJ. Ultrasound as an approach to assessing body composition. Am J Clin Nutr. 1984;39:703–9.PubMed
20.
21.
go back to reference Vlachos IS, Hatziioannou A, Perelas A, et al. Sonographic assessment of regional adiposity. AJR Am J Roentgenol. 2007;189:1545–53.CrossRefPubMed Vlachos IS, Hatziioannou A, Perelas A, et al. Sonographic assessment of regional adiposity. AJR Am J Roentgenol. 2007;189:1545–53.CrossRefPubMed
22.
go back to reference Deschenes D, Couture P, Dupont P, et al. Subdivision of the subcutaneous adipose tissue compartment and lipid-lipoprotein levels in women. Obes Res. 2003;11:469–76.CrossRefPubMed Deschenes D, Couture P, Dupont P, et al. Subdivision of the subcutaneous adipose tissue compartment and lipid-lipoprotein levels in women. Obes Res. 2003;11:469–76.CrossRefPubMed
23.
go back to reference Fox CS, Massaro JM, Hoffmann U, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007;116:39–48.CrossRefPubMed Fox CS, Massaro JM, Hoffmann U, et al. Abdominal visceral and subcutaneous adipose tissue compartments: association with metabolic risk factors in the Framingham Heart Study. Circulation. 2007;116:39–48.CrossRefPubMed
24.
go back to reference Shuster A, Patlas M, Pinthus JH, et al. The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012;85:1–10.CrossRefPubMedPubMedCentral Shuster A, Patlas M, Pinthus JH, et al. The clinical importance of visceral adiposity: a critical review of methods for visceral adipose tissue analysis. Br J Radiol. 2012;85:1–10.CrossRefPubMedPubMedCentral
25.
go back to reference Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11:11–8.CrossRefPubMed Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11:11–8.CrossRefPubMed
26.
go back to reference Callaghan JP, McGill SM. Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin Biomech. 2001;16:28–37.CrossRef Callaghan JP, McGill SM. Intervertebral disc herniation: studies on a porcine model exposed to highly repetitive flexion/extension motion with compressive force. Clin Biomech. 2001;16:28–37.CrossRef
27.
go back to reference Boneva-Asiova Z, Boyanov MA. Body composition analysis by leg-to-leg bioelectrical impedance and dual-energy X-ray absorptiometry in non-obese and obese individuals. Diabetes Obes Metab. 2008;10:1012–8.CrossRefPubMed Boneva-Asiova Z, Boyanov MA. Body composition analysis by leg-to-leg bioelectrical impedance and dual-energy X-ray absorptiometry in non-obese and obese individuals. Diabetes Obes Metab. 2008;10:1012–8.CrossRefPubMed
28.
go back to reference Chouinard LE, Schoeller DA, Watras AC, et al. Bioelectrical impedance vs. four-compartment model to assess body fat change in overweight adults. Obesity. 2007;15:85–92.CrossRefPubMed Chouinard LE, Schoeller DA, Watras AC, et al. Bioelectrical impedance vs. four-compartment model to assess body fat change in overweight adults. Obesity. 2007;15:85–92.CrossRefPubMed
29.
go back to reference Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr. 2004;23:1226–43.CrossRefPubMed Kyle UG, Bosaeus I, De Lorenzo AD, et al. Bioelectrical impedance analysis--part I: review of principles and methods. Clin Nutr. 2004;23:1226–43.CrossRefPubMed
30.
go back to reference Medrano G, Eitner F, Walter M, et al. Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements. Med Biol Eng Comput. 2010;48:531–41.CrossRefPubMed Medrano G, Eitner F, Walter M, et al. Model-based correction of the influence of body position on continuous segmental and hand-to-foot bioimpedance measurements. Med Biol Eng Comput. 2010;48:531–41.CrossRefPubMed
31.
go back to reference Pateyjohns IR, Brinkworth GD, Buckley JD, et al. Comparison of three bioelectrical impedance methods with DXA in overweight and obese men. Obesity. 2006;14:2064–70.CrossRefPubMed Pateyjohns IR, Brinkworth GD, Buckley JD, et al. Comparison of three bioelectrical impedance methods with DXA in overweight and obese men. Obesity. 2006;14:2064–70.CrossRefPubMed
32.
go back to reference Ritchie JD, Miller CK, Smiciklas-Wright H. Tanita foot-to-foot bioelectrical impedance analysis system validated in older adults. J Am Diet Assoc. 2005;105:1617–9.CrossRefPubMed Ritchie JD, Miller CK, Smiciklas-Wright H. Tanita foot-to-foot bioelectrical impedance analysis system validated in older adults. J Am Diet Assoc. 2005;105:1617–9.CrossRefPubMed
33.
go back to reference Rush EC, Crowley J, Freitas IF, et al. Validity of hand-to-foot measurement of bioimpedance: standing compared with lying position. Obesity. 2006;14:252–7.CrossRefPubMed Rush EC, Crowley J, Freitas IF, et al. Validity of hand-to-foot measurement of bioimpedance: standing compared with lying position. Obesity. 2006;14:252–7.CrossRefPubMed
34.
go back to reference Thomson R, Brinkworth GD, Buckley JD, et al. Good agreement between bioelectrical impedance and dual-energy X-ray absorptiometry for estimating changes in body composition during weight loss in overweight young women. Clin Nutr. 2007;26:771–7.CrossRefPubMed Thomson R, Brinkworth GD, Buckley JD, et al. Good agreement between bioelectrical impedance and dual-energy X-ray absorptiometry for estimating changes in body composition during weight loss in overweight young women. Clin Nutr. 2007;26:771–7.CrossRefPubMed
35.
go back to reference Bigaard J, Frederiksen K, Tjonneland A, et al. Waist and hip circumferences and all-cause mortality: usefulness of the waist-to-hip ratio? Int J Obes Relat Metab Disord. 2004;28:741–7.CrossRefPubMed Bigaard J, Frederiksen K, Tjonneland A, et al. Waist and hip circumferences and all-cause mortality: usefulness of the waist-to-hip ratio? Int J Obes Relat Metab Disord. 2004;28:741–7.CrossRefPubMed
36.
go back to reference Peterson MD, Zhang P, Haapala HJ, et al. Greater Adipose Tissue Distribution and Diminished Spinal Musculoskeletal Density in Adults With Cerebral Palsy. Arch Phys Med Rehabil. 2015;96:1828–33.CrossRefPubMedPubMedCentral Peterson MD, Zhang P, Haapala HJ, et al. Greater Adipose Tissue Distribution and Diminished Spinal Musculoskeletal Density in Adults With Cerebral Palsy. Arch Phys Med Rehabil. 2015;96:1828–33.CrossRefPubMedPubMedCentral
37.
go back to reference Marshall P, Murphy B. Delayed abdominal muscle onsets and self-report measures of pain and disability in chronic low back pain. J Electromyogr Kinesiol. 2010;20:833–9.CrossRefPubMed Marshall P, Murphy B. Delayed abdominal muscle onsets and self-report measures of pain and disability in chronic low back pain. J Electromyogr Kinesiol. 2010;20:833–9.CrossRefPubMed
38.
go back to reference Marshall PW, Murphy BA. Evaluation of functional and neuromuscular changes after exercise rehabilitation for low back pain using a Swiss ball: a pilot study. J Manipulative Physiol Ther. 2006;29:550–60.CrossRefPubMed Marshall PW, Murphy BA. Evaluation of functional and neuromuscular changes after exercise rehabilitation for low back pain using a Swiss ball: a pilot study. J Manipulative Physiol Ther. 2006;29:550–60.CrossRefPubMed
39.
go back to reference Marshall PW, Murphy BA. Muscle activation changes after exercise rehabilitation for chronic low back pain. Arch Phys Med Rehabil. 2008;89:1305–13.CrossRefPubMed Marshall PW, Murphy BA. Muscle activation changes after exercise rehabilitation for chronic low back pain. Arch Phys Med Rehabil. 2008;89:1305–13.CrossRefPubMed
40.
go back to reference Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8:1153–7.CrossRefPubMed Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8:1153–7.CrossRefPubMed
41.
go back to reference Chapman JR, Norvell DC, Hermsmeyer JT, et al. Evaluating common outcomes for measuring treatment success for chronic low back pain. Spine. 2011;36:S54–68.CrossRefPubMed Chapman JR, Norvell DC, Hermsmeyer JT, et al. Evaluating common outcomes for measuring treatment success for chronic low back pain. Spine. 2011;36:S54–68.CrossRefPubMed
42.
43.
go back to reference Hawker GA, Mian S, Kendzerska T, et al. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240–52.CrossRef Hawker GA, Mian S, Kendzerska T, et al. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240–52.CrossRef
44.
go back to reference Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17:45–56.CrossRefPubMed Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983;17:45–56.CrossRefPubMed
45.
go back to reference Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine. 2000;25:3115–24.CrossRefPubMed Roland M, Fairbank J. The Roland-Morris Disability Questionnaire and the Oswestry Disability Questionnaire. Spine. 2000;25:3115–24.CrossRefPubMed
46.
go back to reference Egger G, Dixon J. Non-nutrient causes of low-grade, systemic inflammation: Support for a ‘canary in the mineshaft’ view of obesity in chronic disease. Obes Rev. 2011;12:339–45.CrossRefPubMed Egger G, Dixon J. Non-nutrient causes of low-grade, systemic inflammation: Support for a ‘canary in the mineshaft’ view of obesity in chronic disease. Obes Rev. 2011;12:339–45.CrossRefPubMed
47.
go back to reference Gleeson M, Bishop NC, Stensel DJ, et al. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11:607–15.CrossRefPubMed Gleeson M, Bishop NC, Stensel DJ, et al. The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nat Rev Immunol. 2011;11:607–15.CrossRefPubMed
48.
go back to reference Farquhar-Smith WP. Anatomy, physiology and pharmacology of pain. Anaesth Intensive Care. 2008;9:3–7.CrossRef Farquhar-Smith WP. Anatomy, physiology and pharmacology of pain. Anaesth Intensive Care. 2008;9:3–7.CrossRef
49.
go back to reference Briggs MS, Givens DL, Schmitt LC, et al. Relations of C-reactive protein and obesity to the prevalence and the odds of reporting low back pain. Arch Phys Med Rehabil. 2013;94:745–52.CrossRefPubMed Briggs MS, Givens DL, Schmitt LC, et al. Relations of C-reactive protein and obesity to the prevalence and the odds of reporting low back pain. Arch Phys Med Rehabil. 2013;94:745–52.CrossRefPubMed
50.
go back to reference Bigaard J, Thomsen BL, Tjonneland A, et al. Does waist circumference alone explain obesity-related health risk? Am J Clin Nutr. 2004;80:790–1. author reply 791–792.PubMed Bigaard J, Thomsen BL, Tjonneland A, et al. Does waist circumference alone explain obesity-related health risk? Am J Clin Nutr. 2004;80:790–1. author reply 791–792.PubMed
51.
go back to reference Howarth SJ, Callaghan JP. Compressive force magnitude and intervertebral joint flexion/extension angle influence shear failure force magnitude in the porcine cervical spine. J Biomech. 2012;45:484–90.CrossRefPubMed Howarth SJ, Callaghan JP. Compressive force magnitude and intervertebral joint flexion/extension angle influence shear failure force magnitude in the porcine cervical spine. J Biomech. 2012;45:484–90.CrossRefPubMed
52.
go back to reference Brooks C, Siegler JC, Cheema BS, et al. No Relationship Between Body Mass Index and Changes in Pain and Disability After Exercise Rehabilitation for Patients With Mild to Moderate Chronic Low Back Pain. Spine. 2013;38:1–6.CrossRef Brooks C, Siegler JC, Cheema BS, et al. No Relationship Between Body Mass Index and Changes in Pain and Disability After Exercise Rehabilitation for Patients With Mild to Moderate Chronic Low Back Pain. Spine. 2013;38:1–6.CrossRef
53.
go back to reference Ostelo RW, Deyo RA, Stratford P, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33:90–4.CrossRefPubMed Ostelo RW, Deyo RA, Stratford P, et al. Interpreting change scores for pain and functional status in low back pain: towards international consensus regarding minimal important change. Spine. 2008;33:90–4.CrossRefPubMed
Metadata
Title
Relative abdominal adiposity is associated with chronic low back pain: a preliminary explorative study
Authors
Cristy Brooks
Jason C. Siegler
Paul W. M. Marshall
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2016
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-016-3357-6

Other articles of this Issue 1/2016

BMC Public Health 1/2016 Go to the issue