A healthy weight for a healthy back

Experts agree that the best way to achieve and maintain a healthy weight level is through a balanced diet and exercise. For people with many types of back problems, regular exercise and, when necessary, weight loss, can help ease existing back problems and prevent future ones.

Obesity and extra weight can cause low back pain
Along with other health issues that arise from having an unhealthy weight level, obese and overweight patients have an increased risk for back pain, joint pain and muscle strain (1). In particular, overweight patients are more likely to experience problems in their low back than patients at a healthy weight level. This is especially true for people with extra weight around their midsection as the extra weight pulls the pelvis forward, strains the low back and creates low back pain.

In addition to muscle strain, spinal structures such as the discs can be negatively impacted by obesity. Patients with significant excess weight also may experience sciatica and low back pain from a herniated disc or from a pinched nerve if the discs have been damaged from compensating for the extra weight (2).

Weight loss can lower risk for other back problems
Managing weight through nutrition, diet and exercise not only reduces existing back pain, but can also help prevent certain types of back problems in the future. For example, overweight and obese patients have an increased risk for osteoarthritis. The additional strain on the joints from the excess weight can cause arthritis in patients whose Body Mass Index (BMI) is too high. For patients who already have osteoarthritis, weight loss is one of the recommended treatments (3). 

In addition, successful recovery from back surgery may also be affected by a patient’s weight because obese patients run a higher risk of complications and infections from surgery (3). As a result, overweight or obese patients may consider weight loss before major surgery in order to improve their outcome as well as to avoid contributing to further back problems.

For more information about how obesity affects back health and tips for weight loss, please see Weight loss for back pain relief.

Exercise helps with weight loss and back pain
Maintaining a healthy weight usually helps patients to be more consistent with exercise. This is because overweight patients often have fatigue, difficulty breathing or shortness of breath as they exercise, which may cause them to avoid regular physical activity (3).

As a general rule, many patients with back problems believe that they should avoid all exercise in an effort to protect their back from further injury or back pain. However, in reality, inactivity and lack of exercise can actually contribute to future pain and worsen existing problems. Patients are often unaware that movement through gentle exercise stimulates healing and a flow of nutrients within the spine. This is especially important for the discs in the spine. Physical activity causes the discs to swell with water and then squeeze it out, which exchanges nutrients between the discs and other spinal structures. When the patient does not engage in enough physical activity, the spinal discs are deprived of the nutrients they need to stay healthy and functional. The importance of physical activity is explained further in Exercise and fitness to help your back.

Developing a safe weight loss, diet and exercise program
The key to a healthy diet and good nutrition is balance. Patients should consume adequate amounts of vitamins and nutrients but should avoid exceeding the daily intake recommendations for some. Consuming a balanced amount of recommended vitamins and nutrients is also important because certain nutrients and vitamins work in concert while others work against each other. A balanced diet should include a range of healthy foods and, if appropriate, nutritional supplements.

Because of the complexities of developing a healthy diet, exercise and weight loss program, patients should always consult a health professional before starting an exercise routine, changing their diet or taking nutritional supplements. The health professional should help the patient determine any potential limitations and guidelines to follow specific to his or her back problem. With attention to the nutritional content and quantities of food consumed, combined with gentle exercise to control weight, patients will enjoy better back health as well as improved overall health.

References:

1. American Obesity Association. “Health effects of obesity.” AOA Fact Sheets. 2002. http://www.obesity.org/subs/fastfacts/Health_Effects.shtml.

2. Fishman L., Ardman C. Back Pain: How to Relieve Low Back Pain and Sciatica. New York: W.W. Norton & Company, 1997:248.

3. American Obesity Association. “What is obesity?” AOA Fact Sheets. 2002. http://www.obesity.org/subs/fastfacts/obesity_what2.shtml.

By: Kelly Andrews, DC
December 15, 2004