Many people with back pain can point to a specific cause of their pain.

Perhaps it was a car accident, an injury lifting something badly, a football tackle, or a fall from a ladder. And we can usually help you following such traumas to your body. But it is estimated that 80% of adults experience back pain at some time in their lives, and often without any specific trauma, so why do so many other people develop back pain? There can be many other reasons, but too often it is simply because a lot of them are overweight.

Your body was not made to carry around a lot of extra pounds. Even if you are only fifty or sixty pounds overweight, an amount of weight that healthy adults should be able to carry easily on their shoulders, overweight people are likely to carry it in their stomach, hanging over their belt, where it causes their pelvis to tip forward putting an unnatural curve in the spine. Then add to this the fact that obese and overweight people tend to get that way from eating too much and exercising too little. The muscles of the back need exercise to stay toned and strong enough to hold all the bones of the spine in proper alignment. So you have weak back muscles and too much weight in the stomach putting an unnatural curve in the spine and as a result you also have back pain.

The fact is that by recent estimates an amazing 65 percent of Americans are overweight and 31 percent are considered obese.1 Even children are obese with 70 percent of those over 13 trying to lose weight.2 And the problem is growing. The Surgeon General says the number of obese Americans has doubled since 1980 and the number of overweight adolescents has tripled.3 These are frightening numbers, and they account for a great deal of back pain. And it is not just back pain. Being overweight is a leading risk factor for developing type two diabetes, and a major risk factor for heart attacks, strokes, and any number of cancers. A recent study found that obesity is set to soon surpass smoking as this country’s leading cause of preventable death.4

Who's at Risk?

So who is really at risk? Some extra weight distributed throughout your body may not be too harmful, but if you have that spare tire around your middle, it is not just a cosmetic problem. That fat around the waistline, called visceral adipose tissue (VAT) is more harmful than fat stored elsewhere. Excessive VAT is associated with higher levels of fats (triglycerides) in the blood, higher insulin levels, higher blood pressure, and lower levels of protective HDL cholesterol. It increases risk of coronary artery disease, insulin resistance (a precursor to type 2 diabetes called syndrome X), and type 2 diabetes.5 By some accounts men with a waist over 37 inches around and women over 34.5 inches around are at high risk and need to take action.6 Use a tape measure and measure your bare waist just above the hips about an inch below the belly button. This of course does not account for height and is way too generous for shorter persons who would be overweight with smaller waistlines. A more accurate method may be to compute your body mass index (BMI). To calculate that divide your weight in pounds by your height in inches squared (height in inches times height in inches), then multiply by 703. (If that sounds difficult there are automatic BMI calculators on the Internet at http://www.cdc.gov/nccdphp/dnpa/bmi/adult_BMI/english_bmi_calculator/bmi_calculator.htm) Normal BMI is 18.5 – 24.9. Overweight is 25.0 – 29.9 and above 30.0 is considered obese. If you have that spare tire or a BMI above 25, you are at risk.

Genetics are Not to Blame

Some people excuse their obesity believing they are genetically predisposed to being fat. Maybe a fraction of a percent could be but not 65 percent of all Americans. If your parents were overweight they probably ate too much or too much of the wrong foods, and exercised too little. It is true that sedentary people do not burn calories very fast, but that is not a genetic problem. Toned, well-exercised muscles burn lots of calories while you are working out but importantly continue to burn calories throughout the day at much higher rates than out of shape weak muscle tissue. That is why exercise is so vital to losing weight. When sedentary people try to lose weight by nearly starving themselves their bodies begin metabolizing calories even slower in a natural protective mode to prevent starvation. Then if they do eat much of anything the body immediately stores it as fat. It takes eating less and exercising more to get your body metabolism to start burning stored fat calories.

Exercise & Diet Matter Most

Start with the exercise. The easiest is walking. Start walking every day, or at least 5 days a week. Even if you walk just one or two blocks to start, getting started is the most important thing. You must exercise regularly and gradually build up to walking at least a mile a day. That is only 20 minutes at a brisk pace, 30 minutes at a relaxed 2 miles per hour. Then start taking stairs whenever possible and adding other sports and activities or increase your walk to 2 miles a day. Substantial regular exercise is not only essential for losing weight; it makes you feel good, relieves depression, and prevents all sorts of disease.

The other side of the coin is diet. First just eat less of anything you eat. Then start choosing healthy foods. Avoid simple carbohydrates, like simple sugars and refined flour found in most soft drinks, chips, pretzels, crackers, cookies, pastries, breads and baked goods. We recommend you eat a diet rich in fruits, berries, vegetables, nuts, whole grains, and fish, with smaller amounts of lean meats and dairy products if you wish. This leaves out bacon and almost all ground meats (sausage, pepperoni, baloney and all similar lunch meats). If you choose to eat meat, eat small amounts of whole meat like pork loin, chicken or turkey breast, or beef tenderloins. When you go shopping for food, spend most of your time in the produce section and avoid much of the rest of the store. Frozen fruits and vegetables are fine as are some canned fruit and vegetables, but avoid all the convenience prepackaged foods that line most of the shelves. These cost way more than fresh produce and have all sorts of chemicals, preservatives, artificial colors and flavorings, stabilizers, and other fillers which your body does not need. If you look at the ingredients and there is a long list you should probably not buy it. Buy the simple foods.

Just remember that no matter what you eat, without exercise you are unlikely to lose much weight. If you still are not sure of where to begin, ask us for help. We can help you develop an exercise and nutrition plan specifically for you. Of course while you are losing weight we can adjust your spine to help relieve back pain, relieve stress, and promote overall health. A loss in weight usually means a gain in self-image, improved appearance to others, you’ll feel better and have more energy, and you’ll enjoy better spinal health. What could be better?

1. D. Williams, “Blood Sugar Rising,” June 2004, Alternatives, Mountain Home Publishing, Potomac MD, Vol. 10, No. 12, p. 94.
2. Ibid.
3. “Overweight and Obesity Threaten U.S. Health Gains,” Dec. 13, 2001, HHS News, U.S. Dept. of Health & Human Services, (www.surgeongeneral.gov/news/pressreleases/pr_obesity.htm).
4. Journal of the American Medical Association, March 10, 2004 (as reported by A. Weil, “Want to Supersize That?” May 2004, Self Healing, Thorne Communications, Watertown MA, p. 1).
5. J. Whitaker, “Research Roundup,” June 2004, Health & Healing, Phillips Health, LLC, Potomac, MD, Vol. 14, No. 6, p. 5. 6. Ibid.

There have been many studies over the years finding chiropractic care effective for back pain. A new study supports those findings,

showing chiropractic care effective both for acute back pain (lasting less than 7 weeks) and for chronic back pain (lasting more than 7 weeks). It shows chiropractic care to be significantly more effective than traditional medical care for chronic back pain and especially so for back pain patients who also have radiating leg pain below the knee.1

Unlike some previous studies that only evaluated spinal manipulation (which we call adjustments), this study compared traditional medical care to chiropractic care as a whole. While the vast majority of the chiropractic patients in this study did receive adjustments many also were given an exercise plan, self care recommendations, and/or other forms of physical therapy. Medical patients received prescription drugs, exercise plans, and self care advice.

Methods and Scope
of the Study

There were 1855 chiropractic patients of 60 chiropractic doctors from 51 chiropractic clinics and 925 medical patients of 111 medical doctors from 14 general practice community clinics so this was a large broad based study. They were further divided into acute and chronic pain groups so that there were four basic study groups. Patients were evaluated initially by well-accepted standard questionnaires on pain level and on disability. They were followed with these same questionnaires seven additional times over the next four years.

The Results

All four groups reported improvements in pain and disability showing both medical and chiropractic doctors were effective but chiropractic patients in both the acute pain and chronic pain groups did better throughout the entire first year. The advantage of chiropractic care for acute pain was relatively small, but for chronic pain was clinically significant. On a 100-point pain scale, the chiropractic patients with chronic pain scored 12.2 points better at one month and 10.5 points better at 3 months. For disability, the chiropractic patients did better by 8.3 and 8.8 points at one and three months respectively. These advantages remained relatively constant through the first year but by the end of the second year, pain levels in all four groups increased somewhat to where there were no longer significant differences in pain between the medical and chiropractic patients. The advantage in disability for the chiropractic patients during the first year continued through the second year but diminished eventually by the fourth year.
Leg pain often accompanies back pain and the researchers looked at the subgroup of patients with leg pain separately. Here they found that chiropractic patients with pain radiating from the back down below the knee did far better than those under medical care.

Chiropractic patients with chronic pain and pain radiating below the knee reported pain levels an average 21.7 points less than similar medical patients reported at 2 weeks, and at 1, 3, 6, and 12 months their pain stayed at least 18.3 points less than the medical group. The researchers found this to be a clinically important advantage for chiropractic care and concluded, “...chiropractic care demonstrated (an) advantage over medical care for chronic patients in the first year, particularly for those with leg pain radiating below the knee.”2