Thursday, 31 October 2013

Obesity and Low Back Pain

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

C. Low Back Pain
is a common musculoskeletal disorder defined as a condition of pain felt in the lower back. According to the statistic, it affects more than 80% of people at some points in their lives, causing short term missed work related disability.

D. How Obesity associates Back Pain
1. In a study of "The time burden of overweight and obesity in primary care", by Tsai AG, Abbo ED, Ogden LG., posted in PubMed, researcher indicated that We analyzed primary care visits from the 2005 and 2006 National Ambulatory Medical Care Survey (NAMCS) in the United States. Weight-related conditions included diabetes, hypertension, hyperlipidemia, obesity, cardiovascular disease, osteoarthritis, and low back pain and concluded that Approximately 8% of time from primary care visits is attributable to overweight and obesity. This estimate is conservative because the NAMCS only allows for coding of three diagnoses addressed per visit. Estimates of the time burden of overweight and obesity provide data to prioritize weight management for prevention and treatment.

2. According to the study of "Typology of chronic pain among overweight mexican americans" by Zettel-Watson L, Rutledge DN, Aquino JK, Cantero P, Espinoza A, Leal F, Jones CJ., posted in PubMed, researchers found that Data analyses revealed that most participants had widespread pain; 60% were suffering severe pain (including back, knee, and shoulder pain); the most common pain location was head (headache, 80%), followed by knee and upper back (75-76%), shoulder (73%) and lower back (73%). Greater obesity was associated with some negative pain outcomes. Results are relevant for pain management with this at-risk population.

3. In an abstract of the study of "Relationship between body weight gain and significant knee, hip, and back pain in older Americans" by Andersen RE, Crespo CJ, Bartlett SJ, Bathon JM, Fontaine KR., posted in PubMed, researchers indicated that he overall prevalences of knee, hip, and back pain were 21%, 14%, and 22%, respectively. Prevalence estimates for knee (underweight 12.1% to obesity class III 55.7%), hip (underweight 10.4% to obesity class III 23.3%), and back (underweight 20.2% to obesity class III 26.1%) pain increased with increased BMI. Sex-, race-, and age-specific pain prevalence estimates also generally increased at increased levels of BMI.

4. According to the abstract of the study of "The effect of obesity on orthopaedic conditions" by Baumgarten KM, Carlson WO, Watson ES., posted in PubMed, researchers indicated that this review summarizes the known effects of obesity on the musculoskeletal system. Specifically, the effects of obesity on the shoulders, spine, knees, feet and other areas related to sports medicine are examined.

5. According to the study of "[Obesity and low back pain--biology, biomechanics and epidemiology]" [Article in German], by Flamme CH., posted in PubMed, researchers wrote that several studies report a significant association between body weight and low back pain, some do not. Recent research indicates that heredity has a dominant role in disc degeneration and low back pain, although the complex distributions and interactions of genetic factors are currently unknown.

6. According to the abstract of the study of "Body mass index, but not blood pressure is related to the level of pain in persons with chronic pain" by Wood D, Goodnight S, Haig AJ, Nasari T., posted in PubMed, researchers concluded that Contrary to assumptions about acute pain, increased chronic pain does not appear to relate to increased blood pressure. The relationship of obesity with increased pain level among persons who have chronic pain raises the possibility that psychological or physiological mechanisms may be important above and beyond the biomechanical impact of obesity.

7. Etc.

E. Treatments of Obesity and Low Back Pain

1. According to the study of "How to measure the impact of musculoskeletal conditions" by Woolf AD, Vos T, March L., posted in PubMed, researchers found that The increasing number of older people and the changes in lifestyle throughout the world with increasing obesity and reduced physical activity mean that the burden on people and society will increase dramatically. The growing awareness of the burden increases the need for accurate measurement and assessment of the burden as well as measurement of the impact of any public health action. This chapter considers theoretical and practical issues relevant to measuring the buden of musculoskeltal conditions in populations, societies and individuals.

2. In a study of "Obesity and recovery from low back pain: a prospective study to investigate the effect of body mass index on recovery from low back pain" by Mangwani J, Giles C, Mullins M, Salih T, Natali C., posted in PubMed, researchers filed the result of A comparative analysis of the after treatment recovery parameter scores in normal (BMI or= 30 kg/m(2)) patients revealed no significant differences in the mean pain intensity and mean self-experienced impairment and disability scores amongst the groups and concluded that This study demonstrates that BMI does not influence the overall recovery from low back pain in patients undergoing
physiotherapy treatment.

3. According to the study of "Low back pain and lifestyle. Part II--Obesity. Information from a population-based sample of 29,424 twin subjects" by Leboeuf-Yde C, Kyvik KO, Bruun NH., posted in PubMed, researchers found that Obesity is modestly positively associated with low back pain, in particular with chronic or recurrent low back pain. However, because the association is weak, because there is no consistent positive monotonic dose response, and because the link disappears in monozygotic twins who are dissimilar in body mass index, it is unlikely that this association is causal. It is possible, however, that obesity plays a part in the chronicity of simple low back pain. Therefore, those with recurring or long-term low back pain deserve further attention.

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