Weights Effect on The Spine

Weight loss for back relief

The effects of obesity

Patients who are overweight or obese and suffer from back pain may not be aware that their excess weight is actually contributing to their back pain. While it has not been thoroughly studied exactly how excess weight can cause or contribute to back pain, it is known that people who are overweight often are at greater risk for back pain, joint pain and muscle strain than those who are not obese (1).In addition to back pain, symptoms exhibited by persons who are obese or severely overweight may include fatigue, as well as difficulty breathing and shortness of breath during short periods of exercise (2). If the fatigue and shortness of breath
causes one to avoid activity and exercise, then this can indirectly lead to back pain as lack of exercise contributes to many common forms of back pain. This article examines the heightened risk and severity for certain back problems that obese or overweight patients may experience as a result of their weight. The article also provides practical tips and guidelines for how patients can use exercise, diet and weight loss to reduce their back pain.

Problems caused by obesity

According to the American Obesity Association, episodes of musculoskeletal pain, and specifically back pain, are prevalent among the nearly one-third of Americans who are classified as obese (2). The American Obesity Association also reports that more obese persons say they are disabled and less able to complete everyday activities than persons with other chronic conditions (1). Some of the most common obesity-related problems include musculoskeletal and joint related pain (1). For people who are overweight, attention to overall weight loss is important as every pound adds strain to the muscles and ligaments in the
back. In order to compensate for extra weight, the spine can become tilted and stressed unevenly. As a result, over time, the back may lose its proper support and an unnatural curvature of the spine may develop.
In particular, pain and problems in the low back may be aggravated by obesity. This occurs for people with extra weight in their stomachs because the excess weight pulls the pelvis forward and strains the lower back, creating lower back pain. According to the American Obesity Association, women who are obese or who have a large waist size are particularly at risk for lower back pain (1).Obese or overweight patients may experience sciatica and low back pain from a herniated disc. This occurs when discs and other spinal structures are damaged from having to compensate for the pressure of extra weight on the back. In addition, pinched nerves and piriformis syndrome may result when extra weight is pushed into spaces between bones in the low back area (3). Arthritis of the spine that causes back pain may be aggravated when extra body weight strains joints. Those patients with a Body Mass Index (BMI) of greater than 25 are more likely to develop osteoarthritis than those with a lower BMI. The American Obesity Association recommends modest weight loss as a treatment for some types of osteoarthritis (2).The effectiveness of back surgery may also be affected by a patient’s weight. Obese patients are at higher risk for complications and infections after surgery compared to patients who are not obese (2). For seriously overweight patients, paying attention to weight loss before undergoing back surgery may improve the healing process after surgery.

Identifying the need for weight loss

Body Mass Index (BMI) is a measure commonly used by medical practitioners. BMI is a mathematical formula (BMI=kg/m2) that takes into account a person’s weight in kilograms and height in meters and calculates a number. The higher a person’s BMI falls on a pre-determined range of values, the higher the likelihood for obesity.Although there is some debate over the specific meaning of BMI measurements, a BMI of 30 or higher is typically considered to be obese, while a measure of 25 to 29.9 is typically considered to be overweight (4). It is also important to evaluate where excess fat is carried on the patient’s body. Patients wh carry more weight around their midsection are at greater risk for obesity-related health problems, such as low back pain. Weight loss for health considerations is often advisable for women with a waist
measurement of more than 35 inches or men with a waist measurement of more than 40 inches (4).

Barriers to Seeking Pain Relief

Read the Ten Steps below for relief

Many people with chronic pain don't seek pain relief, or even tell their doctors about their pain. Most often, the reasons for keeping pain a secret are based on fears or myths:

• Fear of being labeled as a "bad patient." You won't find relief if you don't talk with your doctor about the pain you feel.
  
• Fear that increased pain may mean that the disease has worsened. Regardless of the state of your disease,the right treatment for pain may improve daily life for you and your family.
  
• Fear of addiction to drugs. Research has shown that the chance of people with chronic pain becoming addicted to pain-relieving drugs is extremely small. When taken properly for pain, drugs can relieve pain without addiction. Needing to take medication to control your pain is not addiction.
  

• Lack of awareness about pain therapy options. Be honest about how your pain feels and how it affects your life. Ask your doctor about the pain therapy options available to you. Often, if one therapy isn't effectively controlling your pain, another therapy can.
  
• Fear of being perceived as "weak." Some believe that living stoically with pain is a sign of strength, while seeking help often is considered negative or weak. This perception prevents them seeking the best treatment with available therapies.
  

Don't let fears and misconceptions keep you from talking to your doctor and other members of your health care team about getting adequate pain relief. Help and relief are possible, but only if you discuss your symptoms with your doctor.

Ten Steps From Patient to Person

American Chronic Pain Association

Making the journey from patient to person takes time. The isolation and fear that can overwhelm a person with chronic pain grows over time. And the return to a fuller, more rewarding life also takes time. It'’s a journey with many phases. The ACPA describes these phases as Ten Steps. The ACPAÂ’s Ten Steps For Moving From Patient To Person.STEP 1: Accept the Pain Learn all you can about your physical condition. Understand that there may be no current cure and accept that you will need to deal with the fact of pain in your life.STEP 2: Get Involved Take an active role in your own recovery. Follow your doctor's advice and ask what you can do to move from a passive role into one of partnership in your own health care.STEP 3: Learn to Set Priorities Look beyond your pain to the things that are important in your life. List the things that you would like to do. Setting priorities can help you find a starting point to lead you back into a more active life.STEP 4: Set Realistic Goals We all walk before we run. Set goals that are within your power to accomplish or break a larger goal down into manageable steps. And take time to enjoy your successes.STEP 5: Know Your Basic Rights We all have basic rights. Among these are the right to be treated with respect, to say no without guilt, to do less than humanly possible, to make mistakes, and to not need to justify your decisions, with words or pain.STEP 6: Recognize Emotions Our bodies and minds are one. Emotions directly affect physical well being. By acknowledging and dealing with your feelings, you can reduce stress and decrease the pain you feel.STEP 7: Learn to Relax Pain increases in times of stress. Relaxation exercises are one way of reclaiming control of your body. Deep breathing, visualization, and other relaxation techniques can help you to better manage the pain you live with.STEP 8: Exercise Most people with chronic pain fear exercise. But unused muscles feel more pain than toned flexible ones. With your doctor, identify a modest exercise program that you can do safely. As you build strength, your pain can decrease. You'll feel better about yourself, too.STEP 9: See the Total Picture As you learn to set priorities, reach goals, assert your basic rights, deal with your feelings, relax, and regain control of your body, you will see that pain does not need to be the center of your life. You can choose to focus on your abilities, not your disabilities. You will grow stronger in your belief that you can live a normal life in spite of chronic pain.STEP 10: Reach Out It is estimated that one person in three suffers with some form of chronic pain. Once you have begun to find ways to manage your chronic pain problem, reach out and share what you know. Living with chronic pain is an ongoing learning experience. We all support and learn from each other.

Helpful Hint: Consider going to a pain management clinic or a pain management specialist. NCPOA can help provide you with information about where to find these clinics and specialists. However, since we cannot evaluate the qualifications of these clinics and specialists, we can only give information, not recommendations. Our article ""Choosing a Pain Clinic or Specialist"" can help you make an educated choice best suited to your individual needs.