Abstract
BACKGROUND CONTEXT
Back pain is the most common musculoskeletal problem in both developed and developing
countries. The prevalence and burden of back pain increases with age, and the management
of back pain becomes increasingly important in the context of global aging. There
is increasing evidence that obesity is a modifiable risk factor for musculoskeletal
pain in different locations. Understanding the role of obesity in back pain holds
great potential for improving understanding of the mechanisms of back pain and for
developing new preventive and therapeutic approaches.
PURPOSE
To evaluate the role of weight, body mass index (BMI) and abdominal circumference
(AC) in risk of back pain over 96 months.
DESIGN
Prospective cohort study.
PATIENT SAMPLE
The sample was from 4,793 adults in the Osteoarthritis Initiative (OAI) database who
had or were at increased risk for knee Osteoarthritis.
OUTCOME MEASURES
Outcome variables included the presence, severity, and frequency of back pain, using
the past 30 days as the time frame.
METHODS
Longitudinal analysis of data from 4,793 participants enrolled in the Osteoarthritis
Initiative, assessed every 12 or 24 months for weight, BMI (kg/m2), AC (cm), and presence, severity (none, mild, moderate, severe), and frequency (none,
rarely, sometimes, often, always) of back pain. BMI and AC were decomposed into between-person
and with-person components. Data analyses were performed using mixed-effects logistic
(for presence of back pain) or ordered logistic regression (for severity and frequency
of back pain) models.
Results
Back pain was reported in 58% of participants at baseline; 70% of those without back
pain had incident back pain over 96 months. Both between-person (average value across
a participant's all measurements) and within-person (deviations from the participant's
average) effects of weight and BMI increased risk of presence, severity, and frequency
of back pain (Odds radios (OR) per kg/m2: 1.010–1.046, p<.05) in females but not males, with statistically significant weight*sex
and BMI*sex interactions. Similar findings were observed for between-person effects
of AC on back pain, and the within-person effect of AC was only associated with back
pain severity (OR per cm: 1.009, 95% confidence interval 1.002–1.017, p=.019) in females.
CONCLUSIONS
Greater average weight and BMI and increases in them increased odds of presence, severity,
and frequency of back pain over 96 months in middle aged and older women but not men.
Only average AC increased odds of back pain over time, in women. These findings suggest
that preventing obesity and slowing weight gain is important for the management of
back pain.
Keywords
Abbreviations:
AC (Abdominal circumference), BMI (body mass index), CI (confidence interval), CES-D (the Center for Epidemiologic Studies Depression scale), ICC (intra-class correlation coefficients), OAI (the Osteoarthritis Initiative), OR (odds ratio), PASE (the Physical Activity Scale for the Elderly)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 05, 2023
Accepted:
March 22,
2023
Received in revised form:
February 20,
2023
Received:
July 21,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
FDA device/drug status: Not applicable.
Author disclosures: XL: Nothing to disclose. YW: Nothing to disclose. YZ: Nothing to disclose. YM: Nothing to disclose. FP: Nothing to disclose. LL: Nothing to disclose. GC: Nothing to disclose.
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