When we see a patient in our office who has joint or back pain and they have clear issues of excessive weight, we try to reassure the patient that we understand that it can be difficult to lose weight. We tell them that we are not going to lecture them and that we will try to present solutions that are realistic. We do have a diet program in our office that can help people, but the choice to diet or make a lifestyle change is up to the patient. One thing is for sure, if we can take off some of the abdominal obesity, our regenerative injection therapy for their back pain can be more effective.
It is not just the weight – you have nerve pain because your fat is generating pain causing inflammation
There has been a large amount of published research, recently released, that suggests that it is not only the mechanical stress that a belly puts on your lower spine, but the runaway inflammation that the belly fat is helping to produce that is attacking your spinal nerves.
A 2016 study published in the journal Pain research and management (1) made these suggestions:
- Obesity could be also related to neuropathic (nerve) pain that is distinct from the musculoskeletal nociceptive pain condition. In other words, there is a pain not originating with tissue damage, it is originating in the body fat of obese people.
- Finding: Results showed that the overweight patients with neuropathic pain complained of more severe pain than the normal-weight patients, in spite of comparable analgesic dosages (i.e., on a proportional body-weight basis).
- In addition, the overweight patients seemed to experience more serious paroxysmal (sudden acute attacks of pain or spasm) pain, and their neuropathic negative symptoms (for example an increase in tingling or numbness) might tend to be aggravated. (So here we have patients who suffer from spasms, acute pain, numbness and tingling sensations caused not by a pinched nerve, but by the inflammation being generated by their abdominal fat.)
The researchers of this study then made this point:
- In obese patients, an increased secretion of proinflammatory cytokines (in simple terms an oxidant or inflammatory for which you would want to be on a diet that promotes anti-oxidants and anti-inflammatory behavior) and a decreased secretion of anti-inflammatory cytokines from adipose tissues are observed, and these can lead to increased levels of proinflammatory cytokines and systemic inflammation.
- This inflammation can lead to peripheral and central sensitization in the pain transmission system and result in hyperalgesia (heightening sense of pain) and allodynia (in some cases, acute pain for no reason, as we mentioned above, sudden acute spasms in the lower back for seemingly no reason – they just happen).
- It can be suggested that lumbar radiculopathy pain can be associated with obesity related inflammation.
Weight loss is back pain management – and it does not take much.
In the April 2019 issue of the European Journal of Pain, (2) researchers made these observations:
- Patients who lost more than 5% of their body weight (a modest 10 pound loss on a 200 pound frame for example) had significant reductions in their low back pain. Imbedding pain management strategies to include weight loss may provide a more holistic approach to obesity management.
Diet can help with your back pain but it is only one aspect
An April 2019 study in the International journal of molecular sciences (3) continued the research into the obesity causing inflammatory factors affecting people with back pain. This research made these suggestions:
- Recent evidence indicates that besides abnormal and excessive mechanical loading (degenerative disc disease), inflammation may be a crucial player in Intervertebral Disc Degeneration. Furthermore, obese adipose (fat) tissue is characterized by a persistent and low-grade production of systemic pro-inflammatory factors. In this context, chronic low-grade inflammation associated with obesity has been hypothesized as an important contributor to degenerative disc disease.
- It is also important to recognize that degenerative disc disease is a complex and multi-factorial disease and thus, further basic and clinical research is needed to fully understand the extent role of inflammation is back pain.
The research suggests that there is a connection between the inflammation your abdominal fat is causing and your back pain. However, there are many factors in play to limit back pain to solely a problem of abdominal fat.
On this website my back pain articles include:
- When surgeons question spinal surgery
- Stem cell therapy for sacroiliac joint dysfunction
- Back pain may be a disc problem. Back pain may be a spinal ligament problem. Researchers ask when to use Stem cells and when to suggest surgery
- Our new research: Platelet-Rich Plasma Injections for Chronic Low Back Pain
- Our new research: Stem Cell Injections for Chronic Low Back Pain
These articles discuss the various problems and challenges we have seen in our patients over the past 20 years. We have found that incorporating these treatments for our problems, with a sensible diet plan, can offer our patients significant back pain relief and make them feel good again.
Ask Dr. Darrow about our diet plan and your back pain
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1. Hozumi J, Sumitani M, Matsubayashi Y, Abe H, Oshima Y, Chikuda H, Takeshita K, Yamada Y. Relationship between Neuropathic Pain and Obesity. Pain Research and Management. 2016 Mar 29;2016.
2 Dunlevy C, MacLellan GA, O’Malley E, Blake C, Breen C, Gaynor K, Wallace N, Yoder R, Casey D, Mehegan J, Fullen BM. Does changing weight change pain? Retrospective data analysis from a national multidisciplinary weight management service. European Journal of Pain. 2019 Apr 9.
3 Ruiz-Fernández C, Francisco V, Pino J, Mera A, González-Gay MA, Gómez R, Lago F, Gualillo O. Molecular Relationships among Obesity, Inflammation and Intervertebral Disc Degeneration: Are Adipokines the Common Link? Int J Mol Sci. 2019 Apr 25;20(8):2030. doi: 10.3390/ijms20082030. PubMed PMID: 31027158; PubMed Central PMCID: PMC6515363.
There is controversy in the medical community about umbilical cord blood stem cells. Some insist that the injectable solution contains abundant live umbilical cord blood stem cells. Some suggest that the stem cells are not alive. I have seen the flow cytometry showing live stem cells. The research shows that these stem cells release cytokines and growth factors that awaken native stem cells. I have tried this treatment on myself for both shoulders and knees. After great success, I started using this treatment on patients. I still use PRP and bone marrow depending on the patient’s pathology and requirements. To date the results are excellent for all of these treatments. We are in the process of doing a study on cord blood stem cells (we have done others on bone marrow and PRP) to see which treatments are the most successful. We are awaiting more long term results.