Obesity and Chronic Pain

Abstract

The combination of obesity and pain may worsen a patient's functional status and quality of life more than each condition in isolation. We systematically searched PubMed/MEDLINE and the Cochrane databases for all reports published on obesity and pain. The prevalence of combined obesity and pain was substantial. Good evidence shows that weight reduction can alleviate pain and diminish pain-related functional impairment. However, inadequate pain control can be a barrier to effective lifestyle modification and rehabilitation. This article examines specific pain management approaches for obese patients and reviews novel interventional techniques for treatment of obesity. The infrastructure for simultaneous treatment of obesity and pain already exists in pain medicine (eg, patient education, behavioral medicine approaches, physical rehabilitation, medications, and interventional treatment). Screening for obesity, pain-related disability, and behavioral disorders as well as monitoring of functional performance should become routine in pain medicine practices. Such an approach requires additional physician and staff training. Further research should focus on better understanding the interplay between these 2 very common conditions and the development of effective treatment strategies.

“What Does Weight Have to Do with It?” Parent Perceptions of Weight and Pain in a Pediatric Chronic Pain Population

“…In their review of the literature on pain and obesity, Narouze and Souzdalnitski [18] indicate that the relationship between obesity and chronic pain has been a focus of attention since the late 1990s, and that the evidence points to a strong association between these chronic conditions. The evidence provided in their review of high-quality studies demonstrates a relationship between obesity and pain in weight-bearing joints, but also between obesity and headache/migraine pain, upper extremity pain, chronic widespread pain and fibromyalgia, abdominal/pelvic pain and chronic neuropathic pain.…”

“…It is noteworthy that multidisciplinary chronic pain management programs commonly include approaches to increase activity [19]. Additionally, it is not uncommon for weight gain to follow injury and pain in childhood [20], and some pain medications (e.g., pregabalin and gabapentin) are associated with weight gain [18]. Therefore, educating parents about the importance of weight, nutrition and physical activity is important, regardless of the weight status of the patient at the time of intake.…”

“…Not addressing [26] weight in children with chronic pain may have devastating lifetime consequences, while addressing [8] weight in this population has the potential to reduce pain and improve functioning. In fact, Narouze and Souzdalnitski [18,27] suggest that the infrastructure to treat both chronic pain and obesity already exists in pain medicine, including medications, physical and psychological rehabilitation, and interventional management. Although these authors provide potentially effective options for the co-management of both conditions, as well as nuances that require consideration for each individual condition, the majority of the research upon which these recommendations have been based has involved adults with co-occurring chronic pain and obesity.…”

Population Characteristics in a Tertiary Pain Service Cohort Experiencing Chronic Non-Cancer Pain: Weight Status, Comorbidities, and Patient Goals

“…Some evidence suggests an association between chronic pain and poor diet quality with higher intakes of energy-dense, nutrient poor foods [8,9]. There are a number of studies that explore the association between obesity and chronic pain, including a recent systematic review summarizing the evidence which supports the notion that there is a higher prevalence of chronic pain in people who are obese, compared to a normal weight population [10]. This review further emphasizes the importance of including weight reduction in chronic pain management [10].…”

“…There are a number of studies that explore the association between obesity and chronic pain, including a recent systematic review summarizing the evidence which supports the notion that there is a higher prevalence of chronic pain in people who are obese, compared to a normal weight population [10]. This review further emphasizes the importance of including weight reduction in chronic pain management [10]. Other studies have also reported a link between greater pain perception and a higher weight status, with individuals classified as obese twice as likely to experience pain [11,12].…”