It’s well known that extra pounds put extra strain on our spine, which can lead to chronic back pain and debilitating spine conditions detracting from our overall health. But back pain – as difficult as it is – is merely one of the spine risks of obesity, with excess pounds creating additional challenges during surgery and post-operative recovery, according to Kaixuan Liu, MD, PhD. Musculoskeletal pain – and specifically back pain – are highly common among the nearly one-third of Americans who are classified as obese, according to the American Obesity Association.

“Every extra pound adds extra strain to the ligaments, joints and muscles in the back,” explains Dr. Liu. “The spine can become tilted and unevenly stressed to compensate for extra weight, especially weight in the abdomen. As a result, obese or overweight people can experience sciatica and pain from herniated discs and other spine conditions aggravated by too many pounds.”

Surgery, post-operative complications heightened by extra weight
But spine risks don’t end with back pain stemming from obesity, Dr. Liu says. Indeed, back pain may be only the beginning of these risks, since chronic backache sometimes leads to surgery to remedy the resulting spine condition.

All types of surgery come with certain risks, but dozens of extra pounds make these risks even more pronounced. Obese patients are at higher risk for complications and infections after any type of surgery compared to those who aren’t obese, according to the American Obesity Association. And a 2012 study published in the journal Spine found that spinal fusion surgery patients who are morbidly obese – about 100 pounds or more overweight – face nearly double the risk of developing complications, such as problems with wound healing or those related to the heart, lungs and kidneys.

Recovering from spine surgery can also be more fraught for those carrying extra weight.

“Moving around after surgery is even harder for obese and overweight patients, and wound care can be an issue when you don’t have the flexibility of a leaner person,” Dr. Liu notes. “This is true of any post-operative recovery, not just in spine surgery, but spine surgery typically follows a long period of having been in pain. The burdens of recovery can feel even greater to those whose motion is somewhat limited.”

Tips for weight management and spine health
Since spinal surgery patients typically suffer far less back pain after their operation and recovery period, they often become more active and then find it easier to control their weight, Dr. Liu notes. And these folks can gain motivation from the fact that managing weight through nutrition and exercise not only reduces any existing back pain, but can prevent new back problems in the future. He offers these tips to promote weight management and overall spine health:

  •     Get medical advice. Overweight patients should speak with their doctor to determine how to safely begin weight loss efforts. “This is important because your exercise program should be adapted to any lingering back pain so you don’t make it worse.”
  •     Start slow. “Even walking a mile or two each day to begin with is a great start to revving up your metabolism and helping your spine to heal from pain or surgery,” Dr. Liu says.
  •     Seek balance. “A strict diet is tough to sustain for the long run,” he says. “Instead, aim for balance among proteins, fruits, vegetables and starches on an everyday basis, and allow yourself the occasional indulgence so you don’t feel deprived.”

“Exercise stimulates healing and a flow of nutrients within the spine itself,” Dr. Liu says. “Getting to – and maintaining – a healthy weight is one of the best things you can do for your total health and that of your spine.”


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