It’s natural to think that weight loss can help you get rid of back pain while managing your risk of heart disease, diabetes, stroke and other degenerative diseases. If you are heavier than your ideal weight, your muscles will need to work harder to help you perform your daily tasks. In addition, the extra load placed on your spine can throw the vertebrae out of alignment, which can lead to joint strain – another potential cause of pain. When you lose weight, you are effectively reducing the stress on your spine and back muscles.
Does Extra Weight Cause Back Pain?
Being overweight, especially around the lower back, may put pressure on your back, although this has not been proven. While there are no definitive studies proving that being overweight causes back pain, it is logical based on clinical evidence. Medical experts will attest that they have not seen an overweight patient who could not find some relief simply by virtue of losing excess weight.
According to the American Obesity Society, episodes of musculoskeletal pain, especially back pain, are common in nearly one-third of Americans classified as obese. Obesity can double or triple the risk. But statistically, losing just four pounds can take 16 pounds of pressure off your spine. In a new study from Hong Kong (where the obesity problem is global), scans of 2,599 women and men showed that piling on the pounds increased the risk of degenerative disc disease by 30 to 79 percent. Overweight children were twice as likely to develop early symptoms of disc disease – leaving them with serious back problems in the future.
Why does Extra Weight Cause Back Pain?
Consider that the spine is forced to support additional upper body weight. The spine is made up of more than 30 small bones called vertebrae that are stacked one on top of the other. Between each vertebra is a spongy piece of cartilage called an intervertebral disc. It acts as a shock absorber and prevents the bony vertebrae from rubbing against each other. Thus, the proper functioning of all these anatomical structures is affected by excess weight.
Ideally, about 50% of the weight of the upper body rests on the lower back, while the other 50% is supported by the abdominal muscles. The extra weight increases the stress on the back muscles and ligaments. Excess weight, especially in the stomach, can shift your center of gravity, causing your spine to become tilted and unevenly stressed, resulting in what is called spinal ectropion (increased curve of the lower back). In addition, belly fat can pump out inflammatory chemicals that weaken the intervertebral discs. Other back conditions caused by being overweight may include sciatica, herniated discs and nerve compression.
Types of Back Pain Related to Obesity
Higher body weight increases the likelihood of developing several serious health conditions, such as type 2 diabetes, high blood pressure and heart disease. Obesity is also associated with conditions that particularly affect the spine and lower back, namely:
- Herniated discs. Patients who are obese or overweight are thought to be more likely to develop a herniated disc, a common cause of leg pain or sciatica from lumbar spondylosis. The disc is more likely to herniate because it is forced to compensate for the pressure of the extra weight on the back.
- Osteoarthritis. Extra weight can strain the joints in the spine, leading to an increased risk of spinal osteoarthritis. A BMI greater than 25 increases the risk of developing osteoarthritis.
Sometimes, degenerative spine disease may require surgery to treat. Obesity is associated with a greater risk of complications or infections in people who require surgery. When medically indicated, surgery is often still worthwhile. Losing weight before undergoing back surgery may help improve the healing process after surgery.
The Best Exercise to Lose Weight and Relieve Back Pain
Research has shown that some exercise programs are more effective than others in assisting with weight loss, reducing chronic low back pain, and improving quality of life and functional ability.
The most beneficial types of exercise include:
- Resistance exercise. The two types of resistance exercises include total body resistance exercises, which strengthen the major muscle groups of the body, and lumbar extension exercises, which focus on the lower back. Full-body resistance exercises are more effective in improving perceived disability (the degree to which an individual perceives their disability) than lumbar extensions. Examples of resistance exercises that do not require weights or resistance bands include squats, push-ups, sit-ups, and push-ups.
- Aquatic exercise. Exercises that are usually too painful to do on land can often be tolerated when done in water. The buoyancy of the water counteracts gravity, supports additional body weight, allows free movement, and provides friction against the movement. Strengthening and conditioning exercises can be easily performed in the water, with a reduced risk of losing balance and causing further injury.
Pilates can also improve lower back pain associated with being overweight, but overweight and obese people tend to be more likely to commit to resistance and water exercises.
Exercise Precautions for People With Back Pain
Although exercise can be very helpful in reducing back pain, there are some conditions that require safety adjustments. For example, exercising during an acute back injury is not recommended. Seek guidance from your health care practitioner or physical therapist if you feel you need it. In the meantime, here are some tips:
- Try to find the right level of intensity and time, not too much and not too little. For example, if you have acute low back pain or sciatica, a good rule of thumb might be to not do exercise, but instead set a goal of avoiding bed rest, but also staying pain-free when returning to daily activities.
- If you just can’t get used to exercise, or if it seems like pain follows your every movement, you may want to try a gentler approach. Activities that seek to relax tension and realign your body posture may help condition your muscles and lubricate your joints. In turn, this may help prevent re-injury and prepare your tissues for more intense exercise.
Some examples of gentler approaches may include water exercise routines or restorative yoga posture sequences that include:
- Pelvic tilt
- Spinal twist
- Cat-cow stretch
- A series of restorative Pilates exercises, aptly named Pre-Pilates, will likely give you a full-body range of motion and a gentle abdominal workout.
- Other gentle but rejuvenating activities include tai chi and feldenkrais.