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PT Misconceptions: Pain & Weight Loss

February 20, 2014 11:03am | CORE PT & MC | by Core Movement Specialists

Low back pain and obesity are both extremely common conditions in the United States.  We are very aware of how excessive weight gain can put us at risk for many health conditions. . . but how many times have you heard someone say, “I just need to lose the extra weight and my muscles or joints will feel better”?  Does weight gain cause musculoskeletal pain?  Well, the answer isn’t that simple.

There is some research that indicates a correlation between obesity and musculoskeletal pain.  However, this research is far from cut and dry when other variables are considered.  In one study listed by the National Institute of Medicine, chronic pain conditions were analyzed in twins.  The study initially found a correlation between chronic pain conditions and obesity.  Overweight and obese twins were more likely to report conditions such as fibromyalgia, migraines, and low back pain.  However, when factors such as familial influences and depression were evaluated, the correlations were reduced.

Studies show that depression can lead to more sedentary behaviors and social withdrawal which can facilitate weight gain in some people.  However, chronic pain conditions such as low back pain and fibromyalgia may also limit one’s social engagements and activities, thus contributing to the obesity correlation.  The important part to remember is that this correlation does not mean that obesity causes pain.  Is there a relationship between obesity and pain?  Yes.  Is pain caused by obesity?  No, not necessarily.  The truth is pain is a complex and multi-faceted issue.  Pain can be caused by many factors, including tissue pathology, biomechanical deficits and poor movement patterns. 

The belief that losing the “extra pounds” will result in pain relief can set some individuals up for failure.  In order to lose weight, people have to move more.  If in doing so, they aggravate underlying musculoskeletal pathology or dysfunction their pain could actually increase and jeopardize their compliance with exercise and weight loss.  Your movement specialist should not only encourage you to move but, also teach you how to move with adequate control.  Understanding how quality of movement will impact your long-term success in weight loss and pain control is imperative.  So, the next time you hear someone say that they just need to “lose a little weight” to get rid of their aches and pains, remind them that when it comes to musculoskeletal pain, our body weight is only one of many variables they can control.  Encourage them to find a trained movement specialist who can help them understand their body, target their individual needs, manage and prevent pain episodes, and help facilitate their goals. 

Stone AA, Broderick JE. Obesity and pain are associated in the United States.  NAASO. 20; 7:1491-1495. doi: 10.1038/oby.2011.397

Wright LJ, Schur E, Noonan C, et al. Chronic pain, overweight, and obesity: findings from a community-based twin registry. J Pain. 2010; 11(7):628-635. doi:  10.1016/j.jpain.2009.10.004.

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