The human spine is designed to support body weight in a biomechanically balanced manner.
However, excess weight—particularly central or abdominal obesity—disrupts this equilibrium,
placing undue stress on spinal structures. This significantly contributes to lower back pain and
accelerates degenerative conditions.

The Spine and Weight : Understanding the Relationship

Excess body mass increases axial loading on the spine, especially in the lumbar region. This can lead
to:
• Intervertebral disc degeneration – Faster wear of spinal cushions, potentially causing
herniation.
• Facet joint overload – Increased pressure may cause inflammation and arthritic changes.
• Altered posture – Obesity often results in lumbar hyperlordosis (excessive inward
curvature), disrupting spinal alignment.
• Muscle deconditioning – Core and paraspinal muscles weaken under sustained stress,
compromising spinal support.

Spinal Conditions Commonly Associated with obesity

1. Degenerative Disc Disease (DDD)
Chronic overloading leads to disc height loss and dysfunction, causing persistent pain.
2. Sciatica
Excess fat and poor spinal alignment can compress the sciatic nerve, producing radiating
pain and numbness.
3. Osteoarthritis
Mechanical wear on spinal joints breaks down cartilage, resulting in stiffness and discomfort.
4. Spinal Stenosis
Obesity can exacerbate spinal canal narrowing, intensifying nerve compression symptoms.

The Therapeutic Impact of Weight Reduction

Clinical studies confirm that weight loss significantly decreases spinal loading. For every 1 kg lost,
spinal pressure may be reduced by 4–7 kg. Key benefits include:
• Decreased inflammatory cytokines impacting disc health
• Improved mobility and functional independence
• Enhanced outcomes from physiotherapy and rehabilitation
• Reduced reliance on analgesic medications

Evidence-Based Weight Management Strategies

Physiotherapy-guided exercise – Emphasises core stability, posture correction, and
strengthening.
• Low-impact aerobic activity – Walking, hydrotherapy, and cycling minimise joint stress.
• Nutritional planning – An anti-inflammatory diet supports tissue repair and weight loss.
• Behavioural support – Addresses emotional eating and ensures sustainable lifestyle
changes.

Clinical Insight

In orthopaedic practice, obesity not only contributes directly to back pain but also complicates
treatment and recovery. A structured, medically supervised approach to weight management is vital
for restoring and maintaining spinal health.
Back pain is more than a symptom—it’s often the result of long-term mechanical overload. Early
orthopaedic intervention, combined with evidence-based weight management, offers the most
effective pathway to recovery and lifelong spinal wellness.