This cycle is one everyone recognizes – when we hurt for a period of time, we are less active and tend to put on weight. In turn, the extra weight makes us hurt more.
Excess body weight puts greater physical strain on the joints and muscles. The “daily grind” of just moving around can especially affect the lower extremities, including the hips, knees, ankles and feet. In fact, among the patients we evaluate before surgery at the N.E.W. Program, severe pain is most often reported in the knees, lower back, feet and hips, in that order. Many have already had knee and hip replacement surgery.
Chronic pain problems and obesity go hand-in-hand. Excess weight slows you down. You get less exercise, less activity in general.
In a study of patients at a local pain clinic,. more than 63 percent of chronic pain patients had moderate to severe obesity. Did the weight cause the pain, or vice versa? Cause and effect doesn’t matter much, although 41 percent of these patients said they were overweight before the onset of their pain. The rest claimed that their weight gain occurred after their pain started.
Medications used to treat pain may work at first, but they ultimately lose their effectiveness and require greater dosages. Some pain medications also lead to weight gain. Gradually increasing physical activity, not medication, is the primary way professionals treat chronic pain. This is often a very difficult goal when pain is severe, especially in a patient with excess body weight.
In many cases, patients find not only significant reductions in extremity pain following weight-loss surgery, but increased activity as well. Some, who were candidates for knee or hip surgery, no longer need it after weight loss.
In a recent study done at the N.E.W. Program, a group of our patients wore pedometers which measure the number of steps taken each day. Patients wore them and recorded their daily steps for one month before and five months after bariatric surgery.
The pedometer reading is an excellent indicator of activity level. Most of our patients increased their activity by more than 100 percent within 6 months after surgery, compared with pre-surgical readings These new results were presented at a San Diego meeting of the American Society for Bariatric Surgery.
When there is excessive body weight, the most effective way to prevent or reduce chronic pain is to lose weight. This is particularly true for those with morbid obesity. In this case, bariatric surgery is a powerful tool to combat chronic pain.