Obesity as a Risk Factor for Low Back Pain: A Meta-Analysis

Clin Spine Surg. 2018 Feb;31(1):22-27. doi: 10.1097/BSD.0000000000000468.

Abstract

Study design: A meta-analysis.

Objective: To update the current knowledge about the association between overweight, obesity, and low back pain (LBP) risk, we conducted a meta-analysis of published cohort studies.

Summary of background data: The association between obesity and LBP risk has been the research focus in the past decade. However, available data from studies on the association between obesity and LBP remains debatable.

Methods: An extensive English language literature retrieval regarding the association between overweight, obesity, and the risk of LBP incidence was conducted on PubMed and EMBASE databases through December 2015. Meta-analysis for all the included literature was performed by STATA 12.0 to summarize test performance with Forest plots after a heterogeneity test. Moreover, subgroup and sensitivity analyses were performed to examine the potential candidate-effect factors.

Results: A total of 10 cohort studies including 29,748 subjects satisfied the predefined eligibility criteria. The pooled odds ratio (OR) for overweight and obesity compared with normal weight was 1.15 [95% confidence interval (CI), 1.08-1.21) and 1.36 (95% CI, 1.18-1.57), respectively. Moreover, subgroup analysis proved that increased body mass index was associated with an increased incidence of LBP in both men (overweight: pooled OR=1.16, 95% CI, 1.04-1.31; obesity: pooled OR=1.36, 95% CI, 1.15-1.61) and women (overweight: pooled OR=1.24, 95% CI, 1.04-1.50; obesity: pooled OR=1.40, 95% CI, 1.08-1.82). There was no evidence of publication bias.

Conclusions: Our findings consistently show that overweight and obesity are risk factors for LBP in men and women. Maintaining a healthy body weight may be one of the factors preventing the occurrence of LBP.

Level of evidence: Level 1.

Publication types

  • Meta-Analysis

MeSH terms

  • Cohort Studies
  • Humans
  • Low Back Pain / etiology*
  • Obesity / complications*
  • Odds Ratio
  • Publication Bias
  • Risk Factors