By JANICE BROWN, MD
Lower back pain is a very common occurrence for the homo sapiens species. Many theories abound as to why, with the main one being that we walk upright on two limbs as opposed to four. Needless to say, lower back pain is a medical condition that has deep economic ramifications.
According to the Centers for Disease Control and Prevention, an estimated 30% of adults have experienced lower back pain; however, about 8% suffer from frequent severe low back pain (1) with an estimated cost of greater than $200 billion per year (2).
Having practiced Physical Medicine and Rehabilitation for the past 10 years and medical acupuncture for six of those years, I have found that the etiology of low back pain encompasses three main categories: disorders of the hard structures (bones, discs), disorders of the soft structures (tendons, ligaments, muscles, nerves) and disorders of the body’s biomechanics (how the lumbar spine moves in relation to the rest of the body).
We sometimes wonder: How does weight loss relate to lower back pain? Well, if you are carrying excessive weight that your musculoskeletal system is not designed to carry, it can wreak havoc on your lumbar spine. This falls under disorders of the body’s biomechanics. Therefore, it is a low-cost, non-invasive fix: Lose weight.
Below is the story of one of my patients and a fellow Lakeland Regional Health team member, Natalie Holmes, whose low back pain journey highlights the struggles that most people face in their quest to control the discomfort as well as the importance of weight loss.
Natalie’s low back pain began well over a year ago on her right side but progressed to her left side months later.
Imaging showed degeneration through her lumbosacral spine. She tried medications (NSAIDs – Aleve, Ibuprofen, Meloxicam; muscle relaxants – Flexeril, Baclofen; epidural steroid injections, Toradol injections; topical medications – Biofreeeze, icy hot), manual modalities (heat, ice, Epsom salt soaks) and therapies (physical therapy, aquatic therapy). She did get some relief, but experienced flare-ups every few months, one of which kept her out of work for a week. Being diabetic with a BMI of 41, she knew she had to lose weight to get her HgbA1c level down and potentially get off diabetic and blood pressure medications. She also was hoping to get better control of her low back pain. As she had a friend/co-worker who was willing to lose weight with her, she dived into a ketosis-based diet at the start of the year. She has since lost 20 pounds, decreased her HgbA1c by 0.2%, gone down two pants sizes and one shirt size, has increased her exercise frequency and more importantly, no longer experiences low back pain.
So before giving up on ways to alleviate your low back pain, especially after trying and failing medications and therapies, consider talking with your primary care provider about what your ideal body weight should be and designing a personalized weight-loss program that can get you to your number. Weight loss works and can be a critical part in the management of an unfortunately common human ailment.
References: Centers for Disease Control and Prevention (March 12, 2019),
Archives of Physical Medicine and Rehabilitaiton (May 2014)
About the Author
Janice Brown, MD, is a Physical Medicine and Rehabilitation Specialist who uses a combination of traditional medicine and medical acupuncture. She sees patients at the Bannasch Institute for Advanced Rehabilitation Medicine and the Grasslands Campus.