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High BMI may be linked to low back pain
Heuch I. Spine. 35(7):764-768. April 2010.
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The results of a large, cross-sectional population study showed that a high body mass index was associated with low back pain.
Ingrid Heuch, MD, from the department of neurology at Oslo University Hospital, in Oslo, and colleagues noted that despite many studies on the topic, it remains unclear whether there is an association between high body mass index (BMI) and low back pain. Using data from the Nord-Trøndelag Health Study (HUNT-2 study), they investigated the link between BMI and chronic low back pain, while adjusting for potential cofounders.
For the HUNT-2 study, the investigators collected data from the county of Nord-Trøndelag, Norway between 1995 and 1997. Heuch and colleagues found that out of 92,936 total HUNT-2 participants, 30,102 men and 33,866 women provided BMI information and indicated whether they suffered from chronic low back pain. A further analysis showed that 6,293 men (20.9%) and 8,923 women (26.3%) had low back pain.
“In both sexes, a high body mass index was significantly associated with an increased prevalence of low back pain,” the authors wrote in their abstract. After adjusting for age, the estimated odds ratio per 5 kg/m2 BMI increase was 1.07 for men and 1.17 for women, with a significantly stronger link for women. Adjusting for education, smoking status, leisure time physical activity, employment status and activity at work had little effect on these associations. Heuch and colleagues found no interactions with most other factors.
This is a large population-based study, but it is unfortunately cross-sectional. Regardless, the results support our meta-analysis, which was published in the American Journal of Epidemiology in January 2010.
The study is significant, mainly because it supports the earlier findings. We need more prospective studies, especially following young patients as they age, to estimate the effect of obesity in musculoskeletal pain and disorders. Most of all, we need these prospective studies to place the role of obesity in context of work-related factors, other lifestyle factors and genetic factors.
– Jaro Karppinen, MD, PhD
Finnish Institute of Occupational Health
Helsinki, Finland
Department of Physical Medicine and Rehabilitation
University of Oulu
Oulu, Finland