Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Sep 14;16(9):e0256720.
doi: 10.1371/journal.pone.0256720. eCollection 2021.

Is adiposity associated with back and lower limb pain? A systematic review

Waruna L Peiris  1 , Flavia M Cicuttini  1 , Sultana Monira Hussain  1 , Mahnuma M Estee  1 , Lorena Romero  2 , Tom A Ranger  1 , Jessica L Fairley  1 , Emily C McLean  1 , Donna M Urquhart  1
Affiliations

Is adiposity associated with back and lower limb pain? A systematic review

Waruna L Peiris et al. PLoS One. .

Abstract

Background: Back and lower limb pain have a major impact on physical function and quality of life. While obesity is a modifiable risk factor for musculoskeletal pain, the role of adiposity is less clear. This systematic review aimed to examine the relationship between both adiposity and its distribution and back and lower limb pain.

Methods: A systematic search of electronic databases was conducted to identify studies that examined the association between anthropometric and/or direct measures of adiposity and site specific musculoskeletal pain. Risk of bias was assessed and a best evidence synthesis was performed.

Results: A total of 56 studies were identified which examined 4 pain regions, including the lower back (36 studies), hip (two studies), knee (13 studies) and foot (eight studies). 31(55%) studies were assessed as having low to moderate risk of bias. 17(30%) studies were cohort in design. The best evidence synthesis provided evidence of a relationship between central adiposity and low back and knee pain, but not hip or foot pain. There was also evidence of a longitudinal relationship between adiposity and the presence of back, knee and foot pain, as well as incident and increasing foot pain.

Conclusions: This systematic review provides evidence of an association between both body fat and its central distribution and low back and knee pain, and a longitudinal relationship between adiposity and back, knee and foot pain. These results highlight the potential for targeting adiposity in the development of novel treatments at these sites.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. GBD 2016 Disease and Injury Incidence and Prevalence Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017; 390(10100): 1211–59. doi: 10.1016/S0140-6736(17)32154-2 - DOI - PMC - PubMed
    1. Briggs AM, Cross MJ, Hoy DG, Sanchez-Riera L, Blyth FM, Woolf AD, et al.. Musculoskeletal Health Conditions Represent a Global Threat to Healthy Aging: A Report for the 2015 World Health Organization World Report on Ageing and Health. The Gerontologist. 2016; 56Suppl 2: S243–55. doi: 10.1093/geront/gnw002 - DOI - PubMed
    1. Gregg E, Shaw J. Global health effects of overweight and obesity. N Engl J Med. 2017; 377(1): 80–1. doi: 10.1056/NEJMe1706095 - DOI - PubMed
    1. Shiri R, Karppinen J, Leino-Arjas P, Solovieva S, Viikari-Juntura E. The Association Between Obesity and Low Back Pain: A Meta-Analysis. American Journal of Epidemiology. 2010; 171(2): 135–54. doi: 10.1093/aje/kwp356 - DOI - PubMed
    1. Butterworth P, Landorf K, Smith S, Menz H. The association between body mass index and musculoskeletal foot disorders: a systematic review. Obes Rev. 2012; 13(7): 630–42. doi: 10.1111/j.1467-789X.2012.00996.x - DOI - PubMed

Publication types