PainSci summary of Dario 2017?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★★★★★5-star ratings are for sentinel studies, excellent experiments with meaningful results. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.
Despite a seemingly “obvious” connection between back pain and obesity, “current evidence remains unclear,” so this study tried to get everything right: a long-term study of over a thousand initially healthy people, measuring both the overall amount of fat as well its distribution, and using twins to control for “the possible effects of genetic and early shared environmental factors.” Quite advanced. And the results? They found nothing: “No increase in the risk of chronic LBP was found for any of the obesity-related measures.” They checked six ways from Sunday, and “obesity-related measures did not increase the risk of developing chronic low back pain.”
original abstract†Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND CONTEXT: Obesity is commonly investigated as a potential risk factor for low back pain (LBP); however, current evidence remains unclear. Limitations in previous studies may explain the inconsistent results in the field, such as the use of a cross sectional design, limitations in the measures used to assess obesity (eg, body mass index-BMI), and poor adjustment for confounders (eg, genetics and physical activity).
PURPOSE AND DESIGN: To better understand the effects of obesity on LBP, our aim was to investigate in a prospective cohort whether obesity-related measures increase the risk of chronic LBP outcomes using a longitudinal design. We assessed obesity through measures that consider the magnitude as well as the distribution of body fat mass. A within-pair twin case-control analysis was used to control for the possible effects of genetic and early shared environmental factors on the obesity-LBP relationship.
PATIENT SAMPLE AND OUTCOME MEASURES: Data were obtained from the Murcia Twin Registry in Spain. Participants were 1,098 twins, aged 43 to 71 years, who did not report chronic LBP at baseline. Follow-up data on chronic LBP >6 months), activity-limiting LBP, and care-seeking for LBP were collected after 2 to 4 years.
RISK FACTORS: The risk factors were BMI, percentage of fat mass, waist circumference, and waist-to-hip ratio.
METHODS: Sequential analyses were performed using logistic regression controlling for familial confounding: (1) total sample analysis (twins analyzed as independent individuals); (2) within-pair twin case-control analyses (all complete twin pairs discordant for LBP at follow-up); and within-pair twin case-control analyses separated for (3) dizygotic and (4) monozygotic twins.
RESULTS: No increase in the risk of chronic LBP was found for any of the obesity-related measures: BMI (men/women, odds ratio [OR]: 0.99; 95 % confidence interval [CI]: 0.86-1.14), % fat mass (women, OR: 0.87; 95% CI: 0.66-1.14), waist circumference (women, OR: 0.98; 95% CI: 0.74-1.30), and waist-to-hip ratio (women, OR: 1.05; 95% CI: 0.81-1.36). Similar results were found for activity-limiting LBP and care-seeking due to LBP. After the adjustment for genetics and early environmental factors shared by twins, the non-significant results remained unchanged.
CONCLUSIONS: After 2 to 4 years, obesity-related measures did not increase the risk of developing chronic LBP or care-seeking for LBP with or without adjustment for familial factors such as genetics in Spanish adults.
- “Fat mass and fat distribution are associated with low back pain intensity and disability: results from a cohort study,” Sultana Monira Hussain, Donna M Urquhart, Yuanyuan Wang, Jonathan E Shaw, Dianna J Magliano, Anita E Wluka, and Flavia M Cicuttini, Arthritis Res Ther, 2017.
One article on PainScience.com cites Dario 2017 as a source:
- Save Yourself from Low Back Pain! — Low back pain myths debunked and all your treatment options reviewed
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Effectiveness of customised foot orthoses for Achilles tendinopathy: a randomised controlled trial. Munteanu 2015 Br J Sports Med.
- A Bayesian model-averaged meta-analysis of the power pose effect with informed and default priors: the case of felt power. Gronau 2017 Comprehensive Results in Social Psychology.
- The neck and headaches. Bogduk 2014 Neurol Clin.
- Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting. Konstantinou 2012 Eur Spine J.
- Effect of NSAIDs on Recovery From Acute Skeletal Muscle Injury: A Systematic Review and Meta-analysis. Morelli 2017 Am J Sports Med.