During evolution states, our ancestral lineage were apes who were quadrupeds (meaning ones who used four limbs for walking). To become bipedal i.e., to stand on two feet straight, the major modification occurred in our spine. It was the key structure involved in standing erect. 

To stand on two feet, the spine needed to bear the weight of our head and torso and transfer it down to our feet. At the same time, it had to be designed in such a way that our flexibility wasn’t compromised. Hence, the fundamental function of our spine became to provide mobility and stability at the same time. 

Looking at it logically, any structure that has to bear weight would have a certain tensile strength, beyond which the structure slowly starts to gives way. Being overweight has a similar effect on our spines. To understand this better, HerZindagi exclusively spoke to Dr Shradha Maheshwari, who is Consultant Neurosurgeon. 

Consultant Neurosurgeon.

“Obesity challenges the tensile strength of our spine causing adjustments in the alignment of the spine. The change in this alignment leads to excessive direct pressure on the back and becomes the starting point of back pain,” explained Dr Maheshwari. 

Although the precise factors responsible for back pain in obese patients remain unclear, “a number of studies clearly correlate the two. Back pain in obese patients establishes slowly over a period of time and impacts overall mobility in these patients which enhances mobility. Obesity and back pain form a vicious cycle which is essential to break,” she said. 

The short-term effects of obesity on the back are reversible with appropriate steps. However, if not tackled in time, obesity can lead to wear and tear of the spine which can cause permanent long-term changes. Dr Maheshwari explained some commonly associated back conditions in obese individuals. 

Low Back Pain

Low Back Pain

This is the first alarm body sends out when their spines are overloaded. The maximum effect of increased body weight occurs in the curvature of the low back region. The lowest arch of the spine, which is the lower back, bears the maximum weight. Increased belly fat changes pull the spine towards the front which is not the appropriate position for the spine. 

In obese individuals, this is backed with a weakened support system too. Often this is the starting point of backache. Loading problems strain the back and overload its joints and need correction in time to prevent serious injury to the back. Mechanical back pain is the first to appear in these patients and is only an indicator that can lead to further serious back problems.

Slipped Disc

Slipped Disc

Most are aware of this term and it is the most commonly used word for back-related problems. The intervertebral discs are the soft cushions in the spine which provide flexibility and movement. Since these are soft and supple in nature, they are the first to bear the brunt of the excess weight. 

The weakened support system and changed alignment of obese individuals make them more prone to slipped discs problems. Often these individuals develop slipped disc even with trivial movements like bending down to pick up the mug while bathing. This can cause acute, severe back pain and leg pain, sometimes making the patient bedridden. This may need surgical intervention for relief of pain.

Osteoarthritis 

Osteoarthritis

Osteoarthritis is a disease of degeneration of the bones and their joints. Degeneration is a natural ageing process and the first to be affected by it are weight-bearing joints i.e. hips, knees and the spine. Obesity hastens this process by increased wear and tear aiding the degenerative process. 

Also, the healing process is slowed down in obese individuals so the healing of this wear and tear is slower making them more vulnerable. The intervertebral discs are first followed by the joints of the spine to be affected by the degenerative process. The intervertebral disc loses its suppleness and becomes flattened to decrease the cushioning effect and height of the spine. The joints in the spine become hypertrophied to accommodate more weight. 

very intricate

But unlike other bones, our spine contains a very intricate and important structure, the Spinal Cord. Our spine is designed to also protect this delicate structure and provide adequate space for it to function appropriately. These changes in the disc and joints (natural remedies for joint pain) to bear the excess weight in the bargain compromise upon the space available for the spinal cord, producing compression on the nerves which gives rise to problems like difficulty in walking, abnormal sensations in the legs, weakness in the legs and sometimes loss of bladder and bowel control. 

As obesity hastens the degenerative process and simultaneously slows down its repair process it is a common cause of osteoarthritis. Generally considered as a disease of old age, osteoarthritis in obese patients can be seen in younger age groups.

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Spondylolisthesis

Spondylolisthesis 

The change in spinal alignment if not taken care of in time causes slippage between the vertebral bodies which in due course of time become permanent leading to Spondylolisthesis. This causes a compromise in spinal canal space causing compression of the nerves and neurological symptoms. 

Along with this slip sometimes even the curvature of the spine (yoga for back pain) changes in other dimensions causing scoliosis. These problems need extensive surgery for correction of the curvature and require fixing the spine with screws and rods. These are often long-term effects on the spine which has been pushed too far to perform their function and are difficult to reverse naturally.

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