Overweight peopleExcess weight is one of the factors
that increase the risk of back pain. However, there are several ways of reducing
this risk. In most cases excess weight is due to the increased fat formation
typical of obesity. However, some sportsmen and sportswomen who intensively practice
certain sports such as weight-lifting and body-building may weigh more than normal
owing to increased muscle mass. Excess weight has been shown to be a risk
factor for the back when it is considerable and due to obesity, but not when it
is due to increased muscle mass. What increases the risk of back pain
in persons who are overweight due to obesity? There are several factors: The
excess weight itself. Excess weight in itself increases the burden on the
vertebral disc, which accelerates wear and increases the risk of deformation or
breakage. It also forces the back muscles to work harder to move the body or maintain
a posture, with heightened risk of spasm and pain. Well-developed and trained
muscles protect the
vertebral disc and increase the load capacity and endurance of the spinal
column. Therefore, if excess weight is due to augmented muscle mass, there is
no increased risk of back trouble. Other associated factors. Persons
whose excess weight is due to obesity are normally exposed to other risk
factors for back pain, such as: Sedentariness,
which in itself increases the risk of back pain.Weakness of the back
and abdominal muscles has been shown to be one of the factors that increase
the risk of new or persisting
pain. Muscular weakness renders the musculature liable to overloading and
spasm in response to apparently slight strains. Moreover, the less muscle mass
there is, the more exposed is the vertebral disc and other structures in the spinal
column, the less is this able to withstand loads, and the greater is the risk
of some spinal disorder.Lack of physical activity. In normal conditions,
the different muscle groups involved in the functioning of the back, such as the
abdominals and the paravertebral musculature, coordinate with one another to maintain
a posture or maintain balance in movement. This coordination depends on nerve
reflexes, which need to be repeated in order to work properly. Physical inactivity
causes loss of training and deterioration of these reflexes, so that the muscles
contract in the wrong way or at the wrong time and become susceptible to spasm.
Poor general health. In the medium and long term, excess weight
increases the risk of various disorders, like metabolic and cardiovascular disease.
Poor general health is one of the factors that increase the risk of back problems.
Can back pain have prejudicial consequences
for a person who is overweight?Yes. Essentially, the risk
of it becoming chronic. As long as excess weight lasts, the back is
continually exposed to a heightened risk
of renewed pain. The repetition and increasing duration of bouts of pain are factors
that increase the risk of the pain persisting for longer or becoming chronic.
Moreover, especially if obese people are not much given to physical
activity, pain may prompt them, wrongly, to repose, to further limit their
physical activity, to adopt an evasive and pessimistic attitude to the pain and
put off starting exercises which have proven to be effective in the treatment
and prevention of back problems. All these factors increase the risk of
pain and functional or work disability appearing, persisting and becoming chronic.
The good news is that there are effective ways of guarding against these
risks. How to prevent and treat back pain in overweight persons.Obviously,
the ideal thing for the back and general health is to reduce weight in the appropriate
way, by limiting and reforming eating habits and doing regular exercise. If this
applies to you, see your doctor and take up whatever program you find most suitable
and comfortable. But even while the excess weight persists, there are
effective ways of preventing back problems, such as: Keep as physically
active as possible. Besides helping you to lose weight and being good for
your general health, keeping as physically active as possible is an effective
way of preventing back pain. In may be as simple as getting used to making day-to-day
journeys on foot rather than sitting in the car, metro or bus, or taking the stairs
up a few flights rather than always taking the elevator. If possible, it is even
better to do some aerobic sports like running or swimming. With 20 or 30 minutes
on alternate days, you will begin to note a considerable difference. If you are
going to start doing a sport regularly, you should first consult a doctor to assess
your general condition and you should observe the rules of postural hygiene in
sports, with which you can do almost any of them with less risk to your back.Know
and observe the rules
of postural hygiene. These teach you how to adopt everyday postures and movements
that involve the least burden for your spinal column and muscles. This is especially
important for overweight people, in whom the load itself is greater than normal.Maintain
and develop the back muscles. Strong back and abdominal muscles reduce the
risk of back problems. This is especially important in people who are overweight,
because the strain on these muscles is greater than normal. In a person with good
muscle strength and endurance, a few extra kilos may not matter to the back. If
done correctly and regularly, some aerobic exercises like swimming may be enough
to keep your back muscles and your general physical condition in good trim. Specific
exercise programs for the back are only effective for these muscles and not for
general fitness, but they require less time and can be alternated with aerobic
exercises when you have time. There is a section of this site that shows effective
exercises for this. If you experience pain, you must
apply the right treatment. This site contains a section that lists all the existing
treatments for back pain, and there is another that indicates the common patterns
of treatments that have proven effective. If the pain that a sedentary
person suffers is shown to be an organic disorder of the spinal column, such as
a herniated disc, the treatments indicated for that disorder should be followed.
These are indicated in the section dealing specifically with fissures, protrusions
and herniated discs. But before treating a herniated disc, we need to
show that this is really what is causing the pain. Thirty per cent of healthy
people who experience no discomfort have protrusions or herniated discs which
cause them no trouble, and signs of vertebral disc wear can be observed in almost
everyone aged over 30. Therefore, any X-ray,
scan or magnetic resonance of a sedentary person will normally show wear
of the vertebral disc, and there will probably be deformation or breakage. But
the image alone is not enough; if there are no symptoms or these do not correspond
exactly to what the image shows, then it is not necessary to apply a specific
treatment. Thirty per cent of the healthy population exhibit protrusions
or herniated discs that produce no symptoms. One day, such people may suffer a
common back pain due to improper functioning of the muscles or to a muscular spasm.
In any case it would be wrong to attribute such symptoms to the herniated disc,
and it would be counter-productive to operate. Therefore, complementary
examinations like X-rays or magnetic resonance should only be performed when there
are concrete grounds to support this. If there are no such grounds, it is pointless
to conduct these examinations given that their results will not modify the treatment.
It could even be counter-productive, since the observation of an unrelated herniated
disc may confuse the diagnosis and lead to incorrect, unnecessarily aggressive
or even counter-productive treatment. It is therefore also essential to
study the characteristics of the symptoms and determine whether or not these correlate
exactly with the organic disorders shown by the image. This means that the clinical
history and physical examination are even more important sources of information
than magnetic resonance. It would be wrong to diagnose a herniated disc without
first interviewing and examining the patient. Only if the patient's symptoms and
the result of the examination correspond exactly to the image does it make sense
to diagnose this as the cause of the pain and establish a treatment on that basis. |
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