Higher Fat Mass Associated With Increased Risk for High-Intensity Low Back Pain

Higher levels of fat mass were found to be associated with higher intensity of back pain and related disability in adults, according to a study published in Arthritis Research & Therapy.

A total of 150 individuals aged 25 to 60 years (mean age, 48.6 years; mean body mass index, [BMI], 32.0 kg/m²) who had undergone dual-energy x-ray absorptiometry within 12 months of answering the Chronic Pain Grade Scale between 2008 and 2009 were enrolled in this study. Of those participants, 123 (82%) completed the 3-year follow-up. The Short Form-36 was used to evaluate patients’ health-related quality of life, and the mental component summary of the Short Form-36 was used to assess participants’ mental health. Physical activity was also assessed with a questionnaire.

The 7-item, self-administered Chronic Pain Grade Scale was used to assess back pain intensity and related disability. A pain intensity score ≥50 on a 0 to 100 scale was considered high intensity, and a score of 3 on a 6-point scale was considered high disability back pain. Resolving high-intensity back pain was characterized by high-intensity back pain at baseline but not at follow-up, and persistent high-intensity back pain was defined as high-intensity back pain at baseline and at follow-up.

The percentages of participants reporting high-intensity back pain at baseline and at follow-up were comparable (22.8% vs 21.1%, respectively). Individuals who reported high-intensity back pain at any time point also had a higher mean BMI compared with patients without high-intensity back pain (mean BMI: resolving pain, 36.5±7.5 kg/m²; developing pain, 37.0±9.5 kg/m²; persistent pain, 36.4±7.9 kg/m²; no high-intensity back pain, 29.7±7.5 kg/m²; P <.001). Patients with high-intensity back pain at any time point had poorer mental health vs patients who did not experience any high-intensity back pain (mean mental component summary score: resolving pain, 42.1±15.6; developing pain, 42.0±16.9; persisting pain, 40.5±15.0; no high-intensity back pain, 48.9±11.7; P =.003).

There was a 5% increased risk for high-intensity back pain for every 1 kg increase in total body fat mass at baseline during the 3-year study period (odds ratio, 1.05; 95% CI, 1.01-1.09; P =.01) after adjusting for confounding variables. An association was established between a higher android to gynoid ratio and high-intensity back pain (multivariable odds ratio, 1.04; 95% CI, 1.01-1.08; P =.009).

Study limitations include the predominance of women in the cohort (78.1%), and the lack of adjustment for depression in the multivariable analysis.

“The results of this study suggest targeting specifically a reduction in fat mass (not just simply weight loss) to prevent back pain, particularly in those who carry excess fat in the android distribution,” noted the study authors.

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Reference

Brady SRE, Urquhart DM, Hussain SM, et al. High baseline fat mass, but not lean tissue mass, is associated with high intensity low back pain and disability in community-based adults. Arthritis Res Ther. 2019;21(1):165.