The association between obesity and low back pain in adults: Data from the 2012 National Health Interview Survey
Being overweight or obese has long been linked with many chronic diseases and disabilities, and has been considered a possible risk factor for low back pain (LBP), but evidence from the literature has been inconsistent. This inconsistency across previous studies may be due, in part, to the use of small and/or homogeneous study populations. The 2012 National Health Interview Survey (NHIS), a cross-sectional survey of a large, representative sample of the general U.S. population, was utilized to address these limitations in the literature. To explore the association between weight status and LBP, body mass index (BMI), based on self-reported height and weight, was used as the exposure variable (i.e., obesity). Reported low back pain during the previous 3 months served as the target outcome. Relevant covariates, such as age, sex, race/ethnicity, and level of physical activity at work and during leisure time were explored in the analysis to more precisely estimate the measure of association. Results from the analysis suggest a linear relationship between BMI and LBP. More specifically, relative to participants with normal weight (BMI<25 kg>/m2), the overweight (25 kg/m2 ≤ BMI < 30 kg/m2) participants had an odds ratio of 1.11 (95% CI: 1.02-1.20) for LBP, while the odds ratio among obese participants (BMI ≥ 30 kg/m2) was 1.55 (95% CI: 1.39-1.63) for LBP. After adjusting for age, sex, race/ethnicity, occupational physical activity, and leisure-time activity, the observed measures of association remained largely unchanged (overweight participants, OR= 1.11, 95% CI: 1.02-1.20; obese participants, OR=1.50, 95% CI: 1.39-1.63). Findings were generally similar when the continuous BMI estimate was utilized (Odds ratio: 1.03 (95% CI: 1.03-1.04). Conclusions: Overweight and obesity are associated with increased prevalence of low back pain in a large, diverse sample of U.S. adults. Further, these relationships remain statistically significant after adjusting for important covariates. These findings support future work to clarify the temporal relationship between obesity and low back pain. Given the established health benefits of maintaining a healthy body weight, clinicians should consider incorporating weight loss counseling into treatment plans for primary and tertiary prevention of low back pain.
Peng, Trent, "The association between obesity and low back pain in adults: Data from the 2012 National Health Interview Survey" (2015). Texas Medical Center Dissertations (via ProQuest). AAI10027723.