Back and Joint Pain and Morbid Obesity.
Being overweight adds considerable extra strain on all weight bearing joints.
Feet, ankle, knee, hip and spine pain are a common symptom for our morbidly obese patients. As far back as 1990, McGoey et al (1) in a case series that examined 105 consecutive Canadian patients with an average preoperative weight of 125 kg, and found that 88 percent of patients had activity limiting chronic Musculoskeletal pain.
Even non weight bearing joints like fingers and elbows can be affected because morbid obesity is an inflammatory condition and Inflammatory Arthritis like Psoriasis and Fybromyalgia are also more common in the morbidly obese. (2)
In many cases the pain in joints is one of the major precipitating factors in patients gaining weight or avoiding exercise to try and lose weight.
In severe cases threatened with joint replacement surgery or back surgery the prognosis for a good functional outcomes and complications are much worse in the morbidly obese. In one study, researchers compared 12,355 normal weight, overweight and obese patients. The number of complications such as re-admissions, leg swelling, bacterial infections, respiratory disorders, neurologic and gastrointestinal problems, were higher for the obese. (3)
Paradoxically, there is not a lot of good evidence that surgery just to relieve back pain results in weight loss. There is no evidence that overweight patients consistently lose weight as a result of lumbar decompression with or without fusion. Two small studies suggest that an overweight patient undergoing lumbar surgery is as likely to gain weight as to lose weight following surgery.(4)
In the same way many studies show that patients undergoing Hip or knee replacement surgery do not see much or any improvement in their weight even with a pain free joint.(5)
What is universally accepted is that joint pain in all areas significantly improves following the weight loss which Bariatric surgery of all types delivers.(6)
In many cases this may forestall or even prevent the need for joint replacement surgery.
If you are suffering from chronic joint pain and morbid obesity and need to see a global improvement in your health as well as alleviate your joint pain then Bariatric surgery may be your best approach.