Back pain and sciatica affect millions of Americans every year. Half a million Americans undergo life changing surgery as a result of the pain, only thirty to thirty-five percent of individuals undergoing surgery reclaim anything approaching a normal, pain-free life. It is important to understand the causes of back pain and sciatica, how to effectively treat the causes, and to know when to see a medical practitioner. The cause of back pain and sciatica to be discussed in this article is obesity. It must be noted that there a myriad of causes, some requiring immediate medical intervention, others requiring a systematic program for recovery, we will discuss the others in future articles. Significantly, the solutions to many of these problems are not that much different, we will explore some of them here.
Obesity has long been recognized as one of the principle causes of back pain and sciatica in adults. Remarkably, as our society gets heavier and obesity reaches epidemic proportions, children are also affected, expressing many of the same symptoms of back pain, and even sciatica, as a consequence of early onset, childhood obesity, and in record numbers. However, it is adults we are primarily concerned with here, and there is a clear and demonstrable link between obesity and back pain among adults in our society. According to the American Obesity Association (AOA), approximately one hundred and ninety-six million adults are considered overweight or obese in the United States, that’s a staggering sixty-four percent of the population, up from forty-six percent (46%) between 1976 and 1980. In addition to back pain and sciatica directly, obesity may also be a contributing factor in a number of other diseases affecting the spine, diseases such as spinal stenosis, degenerative disc disease, osteoarthritis, osteoporosis, spondylolisthesis, and there is even the suggestion of a link between rheumatoid arthritis and obesity in adults, and children.
The spine is divided into four sections or regions, these regions have what are called curvatures, either primary or secondary curvatures. The primary curvatures are the thoracic or mid-chest region, and sacral or “tail bone.” The secondary curvatures are the cervical or neck and the lumbar or lower back. The curvatures are either set prior to birth, as in the case of the primary curvatures or develop in the first year of life, as in the case of the cervical and lumbar curvatures. The spine is meant to support the body as we stand upright, the neck and lower back being the areas at greatest risk due to their natural, weight bearing curvatures and responsibilities. When too much weight is loaded, the back is forced to carry the additional burden, this leads to structural failure and damage, as in the case of herniated discs or even crushed vertebrae. At the very least, the muscles meant to support the back, some quite small and not meant to carry such a heavy load for long periods, are compromised, leading to strain and, in the low back or lumbar region, sway back or lordosis. Imagine putting on a backpack, face front instead of on your back, now load that backpack with bowling balls, one at a time for every ten pounds of extra weight you are carrying. It’s not something you would want to have to carry around all day; and yet, that is exactly what you are doing when you carry extra weight.
Lack of exercise and conditioning, often associated with overweight or obese back pain and sciatica sufferers, leads to an entire complex of consequences. Increased lordosis or sway back, combined with poor flexibility and weak, atrophied or shrunken muscles in the back, primarily the lower back, the hips, thighs, and even calves, leads to improper load bearing and a feedback loop that contributes to more pain, which contributes to more inactivity, which leads to more pain. You get the picture, I hope? This pain complex, with its associated consequences, can increase the secondary curvature of the lower back or lordosis, and may even cause the hips (pelvis) to tilt too far forward and down, causing additional pain. This pelvic tilt, combined with the lordosis or sway back, is detrimental to proper posture of the individual and, as posture disintegrates, other curvatures of the spine, the neck for instance, may become increasingly painful.
Many back pain and sciatica sufferers attempt to downplay the etiology or cause of some or all of their back problems, disorders, and diseases as a natural consequence of aging. It is true that with age-progressive phenomena exist and take place in and on the spine and related musculature. However, much of this is an adaptive response to weakening muscles, muscles that can and should be exercised in order to avoid atrophy and a whole series of problems associated with obesity and aging. There is one thing that is an absolute certainty, if you are carrying extra weight, whether overweight or obese, chances are you have, or will have, back pain and sciatica.