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Will Losing Weight Reduce My Back Pain?

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Updated March 25, 2009

Question: Will Losing Weight Reduce My Back Pain?
It's only natural to assume that, along with controlling your risk for heart attack, diabetes, stroke and other degenerative diseases, losing weight can help you get rid of back pain.
Answer: Yes, experts agree that losing weight successfully often results in partial or complete back pain relief. Dr. Andre Panagos, co-director of The Spine Center at New York Presbyterian Hospital in New York notes, "although research on weight loss and back pain is minimal, in my clinic, every single person who loses a significant amount of weight finds their pain to be significantly improved."

The reason for this, Panagos says, is that if you are above your ideal weight, your muscles will work harder in order to help you accomplish everyday tasks. Another reason is that the extra load on the spine can take vertebrae out of alignment. When you lose weight, you are effectively reducing strain on your spinal column and on your back muscles.

The North American Spine Society recommends staying within 10 pounds of your ideal weight in order to keep your back healthy.

While research has yet to find a causal relationship between obesity and back pain, both patients and practitioners strongly believe there is an association. More and more, health professionals are directing their patients toward making common sense choices, such as maintaining a physically active lifestyle and keeping weight in check, for managing (and preventing) back pain.

Weight loss has many values, beyond the well-being of your back. It can help prevent serious health problems such as heart disease, cancer or diabetes. But whether it's a back ache or the threat of another health issue that gets you going on a weight loss program, it is imperative to put forth the effort. Achieving your ideal weight is an important key to preventing disease and fully participating in your activities.

Physical Activity - Double Benefits of Weight Loss and Back Health
Along with maintaining a healthy diet that restricts calories, engaging in regular physical activity is crucial to achieving your ideal weight. The good news is that physical activity also helps manage back pain. Studies looking at recreational activities show that fit people have less back pain.

Experts agree that exercise is very often the best way to treat, manage and prevent chronic low back pain. In fact, the American Family Physician reports that adhering to an aggressive exercise program as administered by a physical therapist may even help you to avoid the need for back surgery.

Exercise is recommended for people with nearly all types of back pain, but some conditions warrant certain modifications for safety’s sake. You need to find the right level of intensity and time -- not too much, not too little. If you have acute low back pain or sciatica, for example, a good rule of thumb is to set a goal of avoiding bed rest, but remaining pain-free as you resume your daily activities. (Exercise is not recommended during acute low back injury.)

If you just can’t get comfortable with exercise, or it seems as though your pain follows your every move, you may want to try an even gentler approach. Activities that seek to relax tension and realign your body posture may help condition muscles and lubricate joints. In turn, this may help prevent strain and re-injury. Some examples of the gentler approach might include a water exercise routine or restorative yoga pose sequence consisting of:

Also, a restorative series of Pilates exercises, aptly named pre-pilates, will give you a full body range of motion and gentle abdominal workout. Other activities that develop body awareness and/or postural control are tai chi and Feldenkrais. There are exercise options when you're in pain.

Aerobic Activity There is a positive relationship between aerobic activity and the reduction or prevention of back pain. A key ingredient in nearly every type of weight loss program, aerobic activity is any rhythmic motion that uses the large muscles of the body and is maintained continuously. Choosing activities that minimize pounding on your joints is best if your back is hurting. Walking, and in particular, cycling, swimming and aquatic exercise are good low and moderate impact activity choices. A half hour, 5 days per week is the amount of aerobic exercise generally recommended to realize health benefits. If you can’t do that much, start with less and build up in the next few weeks and months, or do several smaller workouts in the same day and accumulate the time.

Strength and Flexibility Strengthening and stretching trunk muscles, (especially the abdominals) and muscles around the hips provides support for upright body posture and for the spine itself. A regular practice of yoga, Pilates or other mind-body workout can help you do just that. Programs such as these work toward developing balanced strength in the muscles that control the pelvis and trunk. This, in turn, can protect your back by facilitating an even wear and tear on your joints and by taking load off your spine.

Sources:

Wai, E., MD, MSc, Rodriguez, S., MD, Dagenais, S. DC, PhD, Hall, H., MD. Evidence-informed management of chronic low back pain with physical activity, smoking cessation, and weight loss. The Spine Journal 8 (2008).
Bigos, S., MD, Holland, J., MD, MPH, Holland, C., PhD, Webster, J., MD, MBA, Battie, M., PhD, Malmgren, J., PhD. High quality controlled trials on preventing episodes of back problems: systematic literature review in working age adults. The Spine Journal 9. (2009).
Khoueir, Paul, MD Co-authors are Mary Helen Black, MS, Peter F. Crookes, MD, Namir Katkhouda, MD, Howard S. Kaufman, MD, and Michael Y. Wang, MD Prospective Assessment of Axial Back Pain Symptoms before and after Bariatric Weight Reduction Surgery, presented at the 76th Annual Meeting of the American Association of Neurological Surgeons in Chicago. April 2008.
Telephone interview. Dr. Neil Vance, DC, Gastonia, NC. Oct 2008.
Email Interview. Panagos, A., MD, Co-Director, The Spine Center, New York Presbyterian Hospital/Weill Cornell Medical Center.
Patel, A., MD, Ogle, A., MD. Diagnosis and Management of Acute Low Back Pain American Family Physician website. March 15, 2000. Accesed March 2009.

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