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Will losing weight help extreme low back pain?

Q: I have extreme low back pain and the doc says "lose weight." Will losing weight help?

A: That's a very good question. Patients with low back pain who are overweight or obese are often advised to lose weight. That sounds like good advise, but some experts question whether there is any evidence that weight loss is linked with reduction of back pain. In other words, is it worth all the calorie restriction, exercise, meal replacement, and group therapy needed to accomplish the goal?

A recent pilot study from Canada was designed to see what they could find out along these lines. They used a medically supervised nonsurgical weight loss program and studied change in back pain. A group of 46 obese adults with mild-to-severe back pain and moderate-to-severe loss of function participated in the study.

Everyone followed a diet and exercise plan for a full year. The first 12 weeks involved a liquid meal program followed by another 13 weeks of reduced food intake. Throughout the first six months, everyone attended group therapy and educational meetings. Physical activity and exercise were a daily requirement (60 to 90 minutes).

Various aspects of the program were supervised by a variety of different health care professionals. This multidisciplinary team was made up of nurses, dieticians, physicians, and exercise specialists.

Before and after results were measured in three main ways: weight loss, pain intensity, and function. After 14 weeks, 98 per cent of the group had lost a significant amount of body weight. Half the group reported major pain relief. Function improved for almost three-fourths of the group (73 per cent).

Those who did lose weight and kept it off had the greatest amount of back pain relief.

The program used involved more than just weight loss. There was also exercise, group support, individual attention, and behavioral changes as part of the whole package. Using a comprehensive program like this did yield some promising results.

More study is needed to find out if all parts combined are really required for change in back pain or if some individual components have a greater impact than others. It's clear that weight loss is beneficial for many things, not just low back pain.

Congratulations on your new found resolve to lose weight and keep it off. You will be rewarded for your efforts in more ways than one. Weight loss benefits the joints, the spine, the heart, and reduces your risk of insulin resistance syndrome, diabetes, and other chronic diseases.

Reference: Darren M. Roffey, PhD, et al. Pilot Evaluation of a Multidisciplinary, Medically Supervised, Nonsurgical Weight Loss Program on the Severity of Low Back Pain in Obese Adults. In The Spine Journal. March 2011. Vol. 11. No. 3. Pp. 197-201.