This episode is entitled “Being overweight and low back pain”. The reasons why obesity affects your low back pain are:

  • Mechanical loading and back pain in overweight people
  • Chemical elements
  • Depression
  • Being overweight affects your sleep and low back pain
  • Lifestyle

Being significantly overweight, even being moderately overweight (not quite in the obese category, but certainly overweight) is a risk factor for lower back pain. It also makes it harder for you to get rid of lower back pain once you have it.

Mechanical loading and back pain in overweight people 

Most overweight people distribute their weight around their middle: men around the abdomen and women around the hips. But being overweight does alter the distribution of weight. Many overweight and obese people have never had lower back pain because they’ve gained weight slowly and steadily, which gives their bodies time to adapt to that change in mechanical loading. The strength of their lower back will probably even be greater because they built muscle to accommodate and compensate for that extra weight.

If you’ve gained weight rapidly, the body doesn’t have that opportunity to adapt as rapidly. You’re more likely to feel that mechanical loading. If you carry the weight on your abdomen, you feel the stream in your lower back. During pregnancy there’s weight gain. It isn’t all fat, a lot of it is the baby and fluid, but the weight it’s very much distributed towards the front and lower back. It won’t all be due to this mechanical loading factor, but it’s a big part of it. All the weight carried at the front, pulling the lower back into hyperlordosis or much increased swerve in the lower back could be a risk factor, or it clearly is in pregnancy for lower back pain.

Chemical elements

Fat is not an inert, it’s not just sitting there, it’s metabolically active. Those fat cells, or dipocytes, produce all sorts of hormones, and that stimulates various different body processes. When a dipocytes swell, when they have more fat in them, they release more pro inflammatory chemicals, tumor necrosis factor is one, interleukin six is another. If you are carrying an excess amount of body fat, your whole body is more likely to be in a state of chronic inflammation, which is likely to sensitize your nerves. This means not only more lower back pain, but also all sorts of things.


Depression is often associated with being overweight. Not in all cases, there are probably millions of overweight people who are happy, but there is a connection. Mood is a huge predictor of the amount of pain that you experience, and it’s possibly the biggest predictor of long-term outcomes for lower back pain / sciatica. Mood and relationships, When you are depressed and or anxious, you are more likely to have higher levels of pain.

Being overweight affects your sleep and low back pain

Overweight people often have poor sleep. The excess body fat affects the airways, closing them slightly when they sleep, and that makes it harder for them to breathe, causing snoring and poor sleep. Pain levels tend to go up again. Sleep has a strong association with pain. If you are sleep deprived, you are much more likely to be in more pain.


Being overweight is a massively complex issue. Losing weight is clearly not easy. There is a genetic component to it, but there is also a lifestyle component to it. Try to create healthy habits, stack the deck in your favor and make it easier on yourself. Eat healthier and more healthfully, exercise and move frequently. It doesn’t have to be formal exercises, just getting up and moving frequently through the day, do some air squats. Every time you go to sit down, do 10 squats in front of your chair and use the chair as your kind of stop point. Don’t rest on the chair, just squat up as if they’re not there. 10 times and then sit down. When you go to get up out of a chair, do 10 squats. Every time you go to the toilet do 10 squats.

If you’d like a free online assessment of lower back pain / sciatica, click the link.