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Excess Weight is a Pain....literally!!!

Often, I find in my practice that many patients who suffer from obesity also suffer from some type of chronic pain.

Most common types of pain complaints I see in patients with excess weight are:

-Knee pain

-Foot pain

-Low back pain



How does excess weight contribute to chronic pain?

There are a few different ways the weight affects pain. The better we understand the cause of a problem, the more effective our solution can be.

- Mechanical Stress- Excess weight exerts increased loading on the joints, leading to more wear and tear. This leads to osteoarthritis in the knees and degeneration of discs in the spine. Obesity also affects body mechanics, posture and gait which can lead to pain.

- Obesity is a pro-inflammatory state. The adipose tissue (aka fat) releases inflammatory chemicals like cytokines, IL-6 etc. which promote inflammation in the tissues and also act on the nervous system to affect pain sensitivity.

- Obesity is associated with low vitamin D levels which can contribute to bone and muscle pain.

- Frequently, obesity is associated with depression and so is chronic pain. According to one study, depression seems to be the most important link between obesity and chronic pain. If one suffers from depression, he/she has decreased motivation for self-care activities like healthy eating, meal-prepping, exercise and meditation. This in turn can worsen both obesity and pain.

- Obesity can lead to poor sleep, especially if when it causes sleep apnea. Inadequate rest can increase pain.

- In some cases, obesity is a result of eating processed, high sugar foods which cause inflammation in the body and increase pain.

Chronic pain can also lead to obesity.

Chronic pain can cause obesity by:

-Hindering movement and exercise

-Food analgesia- eating processed pleasurable foods that take the focus away from pain for a while but are highly calorie dense.

- causing depression.

-Poor sleep because of pain increases stress hormone and hunger hormone levels in the body.

- weight promoting effect of certain medications used for treating chronic pain.

Obesity and chronic pain (and often depression) go hand in hand. If you are suffering from either one of these conditions, help is available. Please reach out to your doctor and start untangling these complex interwoven issues.

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