Dr. Kaliq Chang Offers Tips for Better Back Relief When Obesity Is the Problem

Back PainPreventionPain and Rehab

Unhealthy weight gain may be putting many problems on your back, literally. That concern is echoed by Kaliq Chang MD of Atlantic Spine Center. He says obesity is associated with wear-and-tear on the spine, chronic lower back pain, and exacerbation of other underlying conditions, such as degeneration and herniation of spinal discs, spinal stenosis, a narrowing of the spinal canal, which causes painful pressure on nerves in the spine, and sciatica, irritation of the large nerve extending from the lower back to the legs.

Symptoms of back pain

Severely overweight people can experience back pain combined with symptoms such as fatigue even after short training, shortness of breath, or trouble breathing. Pain in the legs, especially in the knees, is another common symptom. Moreover, like most people with back pain, obese people have increased back pain when bending backward.

Usually, such pain quickly becomes chronic and disturbs a patient on a daily basis.

"The spine plays a critical role in supporting and redistributing body weight. Carrying too much belly weight changes a person's normal biomechanics by pushing the pelvis forward and forcing the spine to curve inward," explains Dr. Chang, an interventional pain-management specialist. "This 'swayback' position places abnormal pressure on the spine and back muscles and is a likely contributor to the development of neck and back pain."

He calls obesity "one of the most serious medical conditions affecting today's society." It can also lead to a host of other health problems, including diabetes, heart disease, peripheral nerve damage, high blood pressure, osteoarthritis, cancer, musculoskeletal pain, and, of course, back problems due to the added stress placed on spinal joints, discs, vertebrae, ligaments, and tendons.

However, poor posture and spinal stress are not necessarily the only culprits in obesity's link to back problems. Dr. Chang concurs with researchers who suggest that obesity also promotes an "inflammatory state" that can trigger or speed spinal disc degeneration and may play a role in compromising the flow of nutrients and oxygen along the spinal tree.

Lower back pain is the second leading cause of disability and early retirement globally. In the United States, it drives an estimated 2.6 million visits annually to hospital emergency departments. Dr. Chang says that approximately 80 percent of the American adult population experience back pain at some point in their lives.

Meanwhile, the percentage of Americans who are overweight or obese is reaching epidemic proportions. According to the latest statistics, the number of adults considered obese ranges as high as 38 percent in some states, with the average overall rate at 31.3 percent. Obesity is defined as having a body mass index (BMI) of 30 or higher. BMI measures how one's weight correlates with age, sex, and height. Recent studies, like the latest report in 2017 by the University of Tokyo Hospital in Japan, have found a direct relationship between high BMI metrics and a greater rate and risk of spinal problems and back pain.

But, obesity's role in overall health, including spinal and back health, is only part of the problem, Dr. Chang states. He refers to a study published in the Global Spine Journal, indicating obese patients are less likely to benefit from nonsurgical treatments for back pain and spine-related issues and are more susceptible to postoperative complications, especially infection and blood clots. "This growing population of obese patients is posing new challenges for spinal surgeons and pain-management specialists," Dr. Chang says.

Increased body weight increases the chance of developing high blood pressure, heart disease, diabetes, and other health conditions.

In the spine and lower back, there’s an increased chance of having a herniated disc, which can result in leg pain or lumbar radiculopathy, which shows as sciatica. It happens because the pressure on back discs is much higher than those with a lower weight.

Osteoarthritis can develop as extra weight triggers joint strains. Remember that several spine conditions need surgical treatment, and excess weight can trigger these conditions or speed up their development. Losing some excess weight can speed up the recovery and serve as a preventive means of future back issues.

Back pain prevention

"Exercise is an important factor in weight loss, but someone with a chronically painful back may be unable to become suddenly more active without medical assistance and treatment," Dr. Chang states. To help patients lose weight, reduce pain and improve overall spinal health, Dr. Chang offers these tips:

  • Work with a healthcare professional to develop a graduated exercise regimen. Even without significant weight reduction, exercise enhances overall fitness, improves cardiovascular health, and decreases the inflammation that promotes lower back pain and impacts the spine.
  • Incorporate walking into a daily routine and consider participating in water-based exercises like swimming. Swimming is a low-impact workout, easy on the back and joints.
  • Be especially conscious of posture. Sit, stand and walk erect, shoulders back.
  • Change diet. Work with a nutritionist to learn what foods are healthiest.
  • Stop smoking; minimize alcohol consumption.

You can also add taking some vitamins if your health care provider doesn’t mind. Vitamin D, Zink, and Calcium are the key nutrients for bone and muscle health. Water is another essential component of your diet, as it improves tissue quality and prevents dehydration.

Even though it can be challenging, consider adding some physical activity to your life, of, course after certain exercises, your back or knee may hurt, but, as Dr. Chang advised, you can try walking or swimming, which give you the benefits of physical activity without disturbing side effects. Your physical therapist can recommend some other overweight-friendly exercises. Remember that small steps performed regularly lead to good long-term results.

Additional Reading on Exercises for the Neck and Back.

Another great tip is to get your overall health checked to determine the cause of excess weight. Sometimes because of hormone disbalance or thyroid issues, people struggle with being overweight, but as these issues are resolved, the extra weight also goes away.

Some doctors can prescribe a special diet to lose excess weight. Usually, it is a low-energy liquid diet. But remember that any diet should be followed under the supervision of your medical team.

Some prescription medicines, including leptin therapy, which is hormonal injections, can be used primarily as a means to prevent the regaining of lost weight. In severe cases, bariatric surgery can be recommended. Such a surgery helps increase the quality of life, lose weight quickly and relieve back pain. But it also has several serious side effects and possible complications.

Also, the cause can be psychological; for example, some people tend to eat to cope with the severity of emotions. So, some people tend to eat excessive amounts of food when stressed, even though they’re not physically hungry. In some cases, therapy, primarily cognitive behavioral therapy, can help you build healthy relationships with food and resolve other issues.