High baseline fat mass, but not lean tissue mass, is associated with high intensity low back pain and disability in community-based adults

Abstract

Objectives Low back pain is the largest contributor to disability worldwide. The role of body composition as a risk factor for back pain remains unclear. Our aim was to examine the relationship between fat mass and fat distribution on back pain intensity and disability using validated tools over 3 years. Methods Participants (aged 25–60 years) were assessed at baseline using dual-energy X-ray absorptiometry (DXA) to measure body composition. All participants completed the Chronic Pain Grade Scale at baseline and 3-year follow-up. Of the 150 participants, 123 (82%) completed the follow-up. Results Higher baseline body mass index (BMI) and fat mass (total, trunk, upper limb, lower limb, android, and gynoid) were all associated with high intensity back pain at either baseline and/or follow-up (total fat mass: multivariable OR 1.05, 95% CI 1.01–1.09, p < 0.001). There were similar findings for all fat mass measures and high levels of back disability. A higher android to gynoid ratio was associated with high intensity back pain (multivariable OR 1.04, 95% CI 1.01–1.08, p = 0.009). There were no associations between lean mass and back pain. Conclusions This cohort study provides evidence for the important role of fat mass, specifically android fat relative to gynoid fat, on back pain and disability.

Circulating Levels of Visceral Adipose Tissue-Derived Serine Protease Inhibitor (Vaspin) Appear as a Marker of Musculoskeletal Pain Disability

“…Association of MSP manifestations with body composition characteristics were also repeatedly reported [ 30 , 31 , 32 , 33 ]. Body mass index (BMI) and other anthropometric measures of obesity were found to be associated with LBP intensity in both men and women [ 34 , 35 , 36 ], suggesting the involvement of AT in LBP pathogenesis. However, in these studies, the peripheral levels of adipokines that can potentially serve as the peripheral molecular LBP biomarkers, have not been assessed.…”

Association Between Fat Distribution and Low Back Pain: Results From The Korean National Health and Nutrition Examination Survey

“…Another found that higher levels of fat mass deposition around the hips were weakly related to increases in the prevalence of CLBP in women through the investigation of 1,128 female twins [13]. There exists evidence on the important role of fat mass, speci cally android fat relative to gynoid fat, in back pain and disability [11]. We found that the total fat mass relative to the total body weight did not differ by CLBP status, except in men with obesity; however, people with CLBP and obesity had a higher fat distribution in the lower limbs than those without CLBP.…”

“…Some previous studies have focused on the association of fat mass distribution with LBP. Brady et al provided evidence on the crucial role of fat mass, especially android fat relative to gynoid fat, in back disability and pain [11]. While Hussain et al showed that LBP-induced pain intensity and disability were related to body composition measures, such as fat mass, fat proportion, and waist circumference, they did not include su cient information on the manner in which regional fat distribution is associated with LBP [12].…”

Plasma Rich in Growth Factors (PRGF) in the Treatment of Cervical and Lumbar Back Pain: A Retrospective Observational Clinical Study

“…In line with this, it would be convenient to increase the sample size of the study, so that stratification by spine sector, age, and gender was effective in all subgroups and had adequate statistical power. In addition, it would have been helpful to have included body mass index values in the study, since being overweight and/or obese are factors that can influence back pain, especially in the lumbar area (42,43).…”