The Effects of Obesity on the Spine & Back

The medical community has long known that obesity and excess weight has a causal relationship to spine disease. Due to the excess weight and resultant stress placed on the spine, it would stand to reason that these joints would have similar issues to other areas of the body that we know are strongly affected by excess weight.

A 2017 study¹ of 23,000 cases was undertaken to understand more about the connection between obesity and spinal disease. The results were very interesting, confirming that there is a positive association between obesity and lower back pain. Moreover, those with spinal diseases, excess weight and obesity were associated with added disability, including increased severity of pain. This study, along with several others, did not show a correlation between obesity and cervical (neck) spine degeneration. This stands to reason as the cervical spine is less correlated to weight versus the lower back.

Analyzing the results of this and other studies, one can draw several interesting conclusions about the effects of obesity as it relates to spinal disease.

• First, it can be understood that increased body weight places additional pressure on the spine, especially the lumbar or lower back. This alone can increase the risk of spinal dysfunction and degeneration including slipped or herniated discs.
• Adding to this, obesity can cause postural changes that can further increase strain on the lower back. For example, patients who are hunched over due to excess weight around the abdomen add stress to the ligaments, muscles and joints in their back.
• As to the increased rate of disability and pain shown in the study, it is inferred that obese patients are generally less active, both due to their weight and due to comorbidities associated with their disease. One of the best remedies for joint pain is exercise, but excess weight often prevents patients from taking advantage of the benefits of exercise.

Treatment for many spinal disorders caused by obesity can include chiropractic manipulation, massage, physical therapy and orthopedic intervention in the form of steroid shots, or in rare cases, surgery. However, as long as the patient remains obese, the effectiveness of these treatments is mitigated. In fact, on the surgical front, excess weight and obesity can increase patient surgical risk significantly, while also increasing the risk of hardware failure.

Part of the answer to slowing or halting degenerative disc disease due to obesity is losing weight. But long-term weight loss without exercise has been proven ineffective in up to 95% of patients. More significant interventions such as weight loss medication, or even weight loss surgery, can be considered after consultation with a knowledgeable primary care physician and orthopedic specialist.

Reference:

• ¹Sheng B, Feng C, Zhang D, Spitler H, Shi L. Associations between Obesity and Spinal Diseases: A Medical Expenditure Panel Study Analysis. Int J Environ Res Public Health. 2017;14(2):183. Published 2017 Feb 13. doi:10.3390/ijerph14020183