Chronic pain management in the obese patient: A focused review of key challenges and potential exercise solutions

Journal of Pain Research

Volumn 8, Issue , 2015, Pages 63-77

  Zdziarski, Laura Ann ^a   Wasser, Joseph G ^a   Vincent, Heather K ^a  

^a UNIVERSITY OF FLORIDA   (United States)

Author keywords

Exercise; Inflammation; Kinesiophobia; Obese; Pain

Indexed keywords

C REACTIVE PROTEIN; INTERLEUKIN 1BETA; INTERLEUKIN 6; INTERLEUKIN 8; LEPTIN; MATRIX METALLOPROTEINASE; TUMOR NECROSIS FACTOR ALPHA;

AEROBIC EXERCISE; ANALGESIA; ARTHRALGIA; ARTICLE; BODY WEIGHT; CHRONIC PAIN; CYTOKINE RELEASE; CYTOKINE RESPONSE; DISEASE ASSOCIATION; EXERCISE INTENSITY; HIP PAIN; HUMAN; INFLAMMATION; JOINT FUNCTION; KINESIOTHERAPY; KNEE PAIN; LOW BACK PAIN; MECHANICAL STRESS; MUSCULOSKELETAL PAIN; OBESITY; PAIN SEVERITY; PATIENT COMPLIANCE; PHYSICAL ACTIVITY; PREVALENCE; PSYCHOLOGICAL ASPECT; RANGE OF MOTION; RESISTANCE TRAINING;

EID: 84922606123     PISSN: None     EISSN: 11787090     Source Type: Journal    
DOI: 10.2147/JPR.S55360     Document Type: Article

References (109)

1. Vincent HK, Adams MCB, Vincent KR, Hurley RW. Musculoskeletal pain, fear avoidance behaviors, and functional decline in obesity: potential interventions to manage pain and maintain function. Reg Anesth Pain Med. 2013;38(6):481–491.
2. Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. PM R. 2012;4(5 Suppl):S45–S52.
3. Andersen RE, Crespo CJ, Bartlett SJ, Bathon JM, Fontaine KR. Relationship between body weight gain and significant knee, hip, and back pain in older Americans. Obes Res. 2003;11(10):1159–1162.
4. Heo M, Allison DB, Faith MS, Zhu S, Fontaine KR. Obesity and quality of life: mediating effects of pain and comorbidities. Obes Res. 2003;11(2):209–216.
5. Anandacoomarasamy A, Caterson ID, Leibman S, et al. Influence of BMI on health-related quality of life: comparison between an obese adult cohort and age-matched population norms. Obesity. 2009;17(11): 2114–2118.
6. Smith SM, Sumar B, Dixon KA. Musculoskeletal pain in overweight and obese children. Int J Obes. 2014;38(1):11–15.
7. Johnson NB, Hayes LD, Brown K, Hoo EC, Ethier KA. CDC National Health Report: leading Causes of Morbidity and Mortality and Associated Behavioral Risk and Protective Factors-United States, 2005–2013. MMWR Surveill Summ. 2014;63:3–27.
8. Glass NA, Torner JC, Frey Law LA, et al. The relationship between quadriceps muscle weakness and worsening of knee pain in the MOST cohort: a 5-year longitudinal study. Osteoarthr Cartil. 2013;21(9): 1154–1159.
9. Yo o JJ, Lim SH, Cho NH, Kim HA. Relationships between body mass index, fat mass, muscle mass, and musculoskeletal pain in community residents. Arthritis Rheumatol. 2014;66(12):3511–3520.
10. Nilsen TIL, Holtermann A, Mork PJ. Physical exercise, body mass index, and risk of chronic pain in the low back and neck/shoulders: longitudinal data from the Nord-Trøndelag health study. Am J Epidemiol. 2011;174(3):267–273.
11. De Sá Pinto AL, De Barros Holanda PM, Radu AS, Villares SM, Lima FR. Musculoskeletal findings in obese children. J Paediatr Child Health. 2006;42(6):341–344.
12. Hannibal KE, Bishop MD. Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther. 2014;94(12):1816–1825.
13. Egan AM, Mahmood WA, Fenton R, et al. Barriers to exercise in obese patients with type 2 diabetes. QJM. 2013;106(7):635–638.
14. Groven KS, Engelsrud G. Dilemmas in the process of weight reduction: exploring how women experience training as a means of losing weight. Int J Qual Stud Health Well-Being. 2010;22:5.
15. Sallinen J, Leinonen R, Hirvensalo M, Lyyra T-M, Heikkinen E, Rantanen T. Perceived constraints on physical exercise among obese and non-obese older people. Prev Med. 2009;49(6):506–510.
16. Shelby RA, Somers TJ, Keefe FJ, Pells JJ, Dixon KE, Blumenthal JA. Domain specific self-efficacy mediates the impact of pain catastrophizing on pain and disability in overweight and obese osteoarthritis patients. J Pain. 2008;9(10):912–919.
17. Lementowski P W, Zelicof SB. Obesity and osteoarthritis. Am J Orthop. 2008;37(3):148–151.
18. Grotle M, Hagen KB, Natvig B, Dahl FA, Kvien TK. Obesity and osteoarthritis in knee, hip and/or hand: an epidemiological study in the general population with 10 years follow-up. BMC Musculoskelet Disord. 2008;9:132.
19. Deere KC, Clinch J, Holliday K, et al. Obesity is a risk factor for musculoskeletal pain in adolescents: findings from a population-based cohort. Pain. 2012;153(9):1932–1938.
20. Gay A, Culliford D, Leyland K, Arden NK, Bowen CJ. Associations between body mass index and foot joint pain in middle-aged and older women: a longitudinal population-based cohort study. Arthritis Care Res. 2014;66(12):1873–1879.
21. Jentzsch T, Geiger J, Slankamenac K, Werner CML. Obesity measured by outer abdominal fat may cause facet joint arthritis at the lumbar spine. J Back Musculoskelet Rehabil. Epub 2014 Jun 24.
22. Fowler-Brown A, Wee CC, Marcantonio E, Ngo L, Leveille S. The mediating effect of chronic pain on the relationship between obesity and physical function and disability in older adults. J Am Geriatr Soc. 2013;61(12):2079–2086.
23. Hitt HC, McMillen RC, Thornton-Neaves T, Koch K, Cosby AG. Comorbidity of obesity and pain in a general population: results from the southern pain prevalence study. J Pain. 2007;8(5):430–436.
24. Zhang W, McWilliams DF, Ingham SL, et al. Nottingham knee osteoarthritis risk prediction models. Ann Rheum Dis. 2011;70(9): 1599–1604.
25. Pain H, Wiles R. The experience of being disabled and obese. Disabil Rehabil. 2006;28(19):1211–1220.
26. Vincent HK, Raiser SN, Vincent KR. The aging musculoskeletal system and obesity-related considerations with exercise. Ageing Res Rev. 2012;11(3):361–373.
27. Evers Larsson U, Mattsson E. Functional limitations linked to high body mass index, age and current pain in obese women. Int J Obes Relat Metab Disord. 2001;25(6):893–899.
28. Garver MJ, Focht BC, Dials J, et al. Weight status and differences in mobility performance, pain symptoms, and physical activity in older, knee osteoarthritis patients. Arthritis. 2014;2014:375909.
29. Rimmer JH, Hsieh K, Graham BC, Gerber BS, Gray-Stanley JA. Barrier removal in increasing physical activity levels in obese African American women with disabilities. J Womens Health. 2010;19(10):1869–1876.
30. Centers for Disease Control and Prevention (CDC). Arthritis as a potential barrier to physical activity among adults with obesity – United States, 2007 and 2009. MMWR Morb Mortal Wkly Rep. 2011; 60(19):614–618.
31. Ball K, Crawford D, Owen N. Too fat to exercise? Obesity as a barrier to physical activity. Aust N Z J Public Health. 2000;24(3):331–333.
32. Atchison J W, Vincent HK. Obesity and low back pain: relationships and treatment. Pain Manag. 2012;2(1):79–86.
33. Tsuritani I, Honda R, Noborisaka Y, Ishida M, Ishizaki M, Yamada Y. Impact of obesity on musculoskeletal pain and difficulty of daily movements in Japanese middle-aged women. Maturitas. 2002;42(1): 23–30.
34. Sharkey JR, Ory MG, Branch LG. Severe elder obesity and 1-year diminished lower extremity physical performance in homebound older adults. J Am Geriatr Soc. 2006;54(9):1407–1413.
35. Viton J-M, Timsit M, Mesure S, Massion J, Franceschi J-P, Delarque A. Asymmetry of gait initiation in patients with unilateral knee arthritis. Arch Phys Med Rehabil. 2000;81(2):194–200.
36. Constantinou M, Barrett R, Brown M, Mills P. Spatial-temporal gait characteristics in individuals with hip osteoarthritis: a systematic literature review and meta-analysis. J Orthop Sports Phys Ther. 2014;44(4): 291–B7.
37. Hills A P, Parker AW. Gait characteristics of obese children. Arch Phys Med Rehabil. 1991;72(6):403–407.
38. Andriacchi T P, Favre J. The nature of in vivo mechanical signals that infuence cartilage health and progression to knee osteoarthritis. Curr Rheumatol Rep. 2014;16(11):463.
39. Mills K, Hettinga BA, Pohl MB, Ferber R. Between-limb kinematic asymmetry during gait in unilateral and bilateral mild to moderate knee osteoarthritis. Arch Phys Med Rehabil. 2013;94(11):2241–2247.
40. Eitzen I, Fernandes L, Nordsletten L, Snyder-Mackler L, Risberg MA. Weight-bearing asymmetries during Sit-To-Stand in patients with mild-to-moderate hip osteoarthritis. Gait Posture. 2014;39(2):683–688.
41. Marks R. Obesity profiles with knee osteoarthritis: correlation with pain, disability, disease progression. Obesity. 2007;15(7):1867–1874.
42. Butterworth PA, Urquhart DM, Cicuttini FM, et al. Fat mass is a predictor of incident foot pain. Obesity. 2013;21(9):E495–E499.
43. Messier S P, Gutekunst DJ, Davis C, DeVita P. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis Rheum. 2005;52(7):2026–2032.
44. Kaur J. A comprehensive review on metabolic syndrome. Cardiol Res Pract. 2014;2014:943162.
45. Marcus DA. Obesity and the impact of chronic pain. Clin J Pain. 2004;20(3):186–191.
46. Cesari M, Kritchevsky SB, Baumgartner RN, et al. Sarcopenia, obesity, and inflammation – results from the Trial of Angiotensin Converting Enzyme Inhibition and Novel Cardiovascular Risk Factors study. Am J Clin Nutr. 2005;82(2):428–434.
47. Seaman DR. Body mass index and musculoskeletal pain: is there a connection? Chiropr Man Therap. 2013;21:15.
48. Paradowski PT, Englund M, Lohmander LS, Roos EM. The effect of patient characteristics on variability in pain and function over two years in early knee osteoarthritis. Health Qual Life Outcomes. 2005;3:59.
49. Messier S P, Pater M, Beavers D P, et al. Influences of alignment and obesity on knee joint loading in osteoarthritic gait. OsteoarthritisCartilage. 2014;22(7):912–917.
50. Monteiro M, Gabriel R, Aranha J, Neves e Castro M, Sousa M, Moreira M. Influence of obesity and sarcopenic obesity on plantar pressure of postmenopausal women. Clin Biomech. 2010;25(5):461–467.
51. Fabris SM, Faintuch J, Brienze SL, et al. Are knee and foot orthopedic problems more disabling in the superobese? Obes Surg. 2013;23(2): 201–204.
52. Andriacchi T P, Mündermann A, Smith RL, Alexander EJ, Dyrby CO, Koo S. A framework for the in vivo pathomechanics of osteoarthritis at the knee. Ann Biomed Eng. 2004;32(3):447–457.
53. Menegoni F, Galli M, Tacchini E, Vismara L, Cavigioli M, Capodaglio P. Gender-speciflc effect of obesity on balance. Obesity. 2009;17(10): 1951–1956.
54. Gupta M, Dashottar A, Borstad JD. Scapula kinematics differ by body mass index. J Appl Biomech. 2013;29(4):380–385.
55. Samartzis D, Karppinen J, Cheung J, Lotz J. Disk degeneration and low back pain: are they fat-related conditions? Global Spine J. 2013;03(03):133–144.
56. Galli MM, Protzman NM, Mandelker EM, Malhotra A, Schwartz E, Brigido SA. Comparing tendinous and ligamentous ankle pathology in atraumatic overweight and nonoverweight patients: a comprehensive MRI review. Foot Ankle Spec. 2014;7(6):449–456.
57. Irwin MR. Inflammation at the intersection of behavior and somatic symptoms. Psychiatr Clin North Am. 2011;34(3):605–620.
58. Arranz L-I, Rafecas M, Alegre C. Effects of obesity on function and quality of life in chronic pain conditions. Curr Rheumatol Rep. 2014; 16(1):1–8.
59. Briggs MS, Givens DL, Schmitt LC, Taylor CA. Relations of C-reactive protein and obesity to the prevalence and the odds of reporting low back pain. Arch Phys Med Rehabil. 2013;94(4):745–752.
60. Bas S, Finckh A, Puskas GJ, et al. Adipokines correlate with pain in lower limb osteoarthritis: different associations in hip and knee. Int Orthop. 2014;38(12):2577–2583.
61. Sokolove J, Lepus CM. Role of inflammation in the pathogenesis of osteoarthritis: latest findings and interpretations. Ther Adv Musculoskelet Dis. 2013;5(2):77–94.
62. Goldring MB, Otero M. Inflammation in osteoarthritis. Curr Opin Rheumatol. 2011;23(5):471–478.
63. Vincent HK, Omli MR, Day T, Hodges M, Vincent KR, George SZ. Fear of movement, quality of life, and self-reported disability in obese patients with chronic lumbar pain. Pain Med. 2011;12(1):154–164.
64. Hoftun GB, Romundstad PR, Rygg M. Factors associated with adolescent chronic non-specific pain, chronic multisite pain, and chronic pain with high disability: the Young-HUNT Study 2 008. J Pain. 2012;13(9):874–883.
65. Somers TJ, Wren AA, Blumenthal JA, Caldwell D, Huffman KM, Keefe FJ. Pain, physical functioning, and overeating in obese rheumatoid arthritis patients: do thoughts about pain and eating matter? J Clin Rheumatol. 2014;20(5):244–250.
66. Daly M. The relationship of C-reactive protein to obesity-related depressive symptoms: a longitudinal study. Obesity (Silver Spring). 2013;21(2):248–250.
67. Capuron L, Poitou C, Machaux-Tholliez D, et al. Relationship between adiposity, emotional status and eating behaviour in obese women: role of inflammation. Psychol Med. 2011;41(7):1517–1528.
68. Slavich GM, Irwin MR. From stress to inflammation and major depressive disorder: a social signal transduction theory of depression. PsycholBull. 2014;140(3):774–815.
69. Somers TJ, Keefe FJ, Pells JJ, et al. Pain catastrophizing and pain-related fear in osteoarthritis patients: relationships to pain and disability. J Pain Symptom Manage. 2009;37(5):863–872.
70. Somers TJ, Keefe FJ, Carson J W, Pells JJ, LaCaille L. Pain catastroph-izing in borderline morbidly obese and morbidly obese individuals with osteoarthritic knee pain. Pain Res Manag. 2008;13(5):401–406.
71. Somers TJ, Blumenthal JA, Guilak F, et al. Pain coping skills training and lifestyle behavioral weight management in patients with knee osteoarthritis: a randomized controlled study. Pain. 2012;153(6): 1199–1209.
72. Gooberman-Hill R, Woolhead G, MacKichan F, Ayis S, Williams S, Dieppe P. Assessing chronic joint pain: lessons from a focus group study. Arthritis Care Res. 2007;57(4):666–671.
73. Vincent HK, Lamb KM, Day TI, Tillman SM, Vincent KR, George SZ. Morbid obesity is associated with fear of movement and lower quality of life in patients with knee pain-related diagnoses. PM R. 2010;2(8): 713–722.
74. Vincent HK, Seay AN, Montero C, Conrad B P, Hurley RW, Vincent KR. Kinesiophobia and fear-avoidance beliefs in overweight older adults with chronic low-back pain: relationship to walking endurance – part II. Am J Phys Med Rehabil. 2013;92(5):439–445.
75. Snow R, Ruane J, LaLonde M, et al. Randomized trial assessing the impact of a musculoskeletal intervention for pain before participating in a weight management program. [Miscellaneous Article]. J Cardiopulm Rehabil Prev. 2010;30(3):173–180.
76. Paans N, van den Akker-Scheek I, Dilling RG, et al. Effect of exercise and weight loss in people who have hip osteoarthritis and are overweight or obese: a prospective cohort study. Phys Ther. 2013;93(2): 137–146.
77. Doi T, Akai M, Fujino K, et al. Effect of home exercise of quadriceps on knee osteoarthritis compared with nonsteroidal antiinfammatory drugs: a randomized controlled trial. Am J Phys Med Rehabil. 2008;87(4): 258–269.
78. Escalante Y, García-Hermoso A, Saavedra JM. Effects of exercise on functional aerobic capacity in lower limb osteoarthritis: a systematic review. J Sci Med Sport. 2011;14(3):190–198.
79. Escalante Y, Saavedra JM, García-Hermoso A, Silva AJ, Barbosa TM. Physical exercise and reduction of pain in adults with lower limb osteoarthritis: a systematic review. J Back Musculoskelet Rehabil. 2010; 23(4):175–186.
80. Ettinger WH Jr, Burns R, Messier S P, et al. A randomized trial comparing aerobic exercise and resistance exercise with a health education program in older adults with knee osteoarthritis. The Fitness Arthritis and Seniors Trial (FAST). JAMA. 1997;277(1):25–31.
81. Farr JN, Going SB, McKnight PE, Kasle S, Cussler EC, Cornett M. Progressive resistance training improves overall physical activity levels in patients with early osteoarthritis of the knee: a randomized controlled trial. Phys Ther. 2010;90(3):356–366.
82. Fransen M, McConnell S. Exercise for osteoarthritis of the knee. Cochrane Database Syst Rev. 2008;(4):CD004376.
83. Fransen M, McConnell S. Land-based exercise for osteoarthritis of the knee: a metaanalysis of randomized controlled trials. J Rheumatol. 2009;36(6):1109–1117.
84. Strine T W, Hootman JM. US national prevalence and correlates of low back and neck pain among adults. Arthritis Care Res. 2007;57(4): 656–665.
85. Vincent HK, Seay AN, Montero C, Conrad B P, Hurley RW, Vincent KR. Functional pain severity and mobility in overweight older men and women with chronic low-back pain – part I. Am J Phys Med Rehabil. 2013;92(5):430–438.
86. Vincent HK, George SZ, Seay AN, Vincent KR, Hurley RW. Resistance exercise, disability, and pain catastrophizing in obese adults with back pain. Med Sci Sports Exerc. 2014;46(9):1693–1701.
87. Vincent HK, Vincent KR, Seay AN, Conrad B P, Hurley RW, George SZ. Back strength predicts walking improvement in obese, older adults with chronic low back pain. PM R. 2014;6(5):418–426.
88. Miltner O, Wirtz DC, Siebert CH. Strengthening lumbar extensors – therapy of chronic back pain – an overview and meta-analysis. Z Orthop Ihre Grenzgeb. 2001;139(4):287–293.
89. Brosseau L, Wells GA, Tugwell P, et al. Ottawa panel evidence-based clinical practice guidelines for the management of osteoarthritis in adults who are obese or overweight. Phys Ther. 2011;91(6): 843–861.
90. Brosseau L, Wells GA, Kenny G P, et al. The implementation of a community-based aerobic walking program for mild to moderate knee osteoarthritis: a knowledge translation randomized controlled trial: part II: clinical outcomes. BMC Public Health. 2012;12:1073.
91. Foroughi N, Smith RM, Lange AK, Singh MAF, Vanwanseele B. Progressive resistance training and dynamic alignment in osteoarthritis: a single-blind randomised controlled trial. Clin Biomech (Bristol Avon). 2011;26(1):71–77.
92. McKnight PE, Kasle S, Going S, et al. A comparison of strength training, self-management, and the combination for early osteoarthritis of the knee. Arthritis Care Res. 2010;62(1):45–53.
93. Lim B-W, Hinman RS, Wrigley T V, Sharma L, Bennell KL. Does knee malalignment mediate the effects of quadriceps strengthening on knee adduction moment, pain, and function in medial knee osteoarthritis? A randomized controlled trial. Arthritis Rheum. 2008;59(7):943–951.
94. Lim J-Y, Tchai E, Jang S-N. Effectiveness of aquatic exercise for obese patients with knee osteoarthritis: a randomized controlled trial. PM R. 2010;2(8):723–731.
95. Jenkinson CM, Doherty M, Avery AJ, et al. Effects of dietary intervention and quadriceps strengthening exercises on pain and function in overweight people with knee pain: randomised controlled trial. BMJ. 2009;339:b3170.
96. Messier S P, Mihalko SL, Legault C, et al. Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the idea randomized clinical trial. JAMA. 2013;310(12):1263–1273.
97. Oyeyemi AL. Body mass index, pain and function in individuals with knee osteoarthritis. Niger Med J. 2013;54(4):230–235.
98. Messier S P, Loeser R F, Miller GD, et al. Exercise and dietary weight loss in overweight and obese older adults with knee osteoarthritis: the Arthritis, Diet, and Activity Promotion Trial. Arthritis Rheum. 2004;50(5):1501–1510.
99. Campos RM, de Mello MT, Tock L, et al. Aerobic plus resistance training improves bone metabolism and inflammation in adolescents who are obese. J Strength Cond Res. 2014;28(3):758–766.
100. Nimmo MA, Leggate M, Viana JL, King JA. The effect of physical activity on mediators of inflammation. Diabetes Obes Metab. 2013;15(s3):51–60.
101. Annesi JJ, Whitaker AC. Weight loss and psychologic gain in obese women – participants in a supported exercise intervention. Perm J. 2008;12(3):36–45.
102. Donnelly JE, Blair SN, Jakicic JM, Manore MM, Rankin J W, Smith BK. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009;41(2):459–471.
103. Seagle HM, Strain G W, Makris A, Reeves RS, American Dietetic Association. Position of the American Dietetic Association: weight management. J Am Diet Assoc. 2009;109(2):330–346.
104. Rao G, Burke LE, Spring BJ, et al. New and emerging weight management strategies for busy ambulatory settings a scientific statement from the American Heart Association endorsed by the society of behavioral medicine. Circulation. 2011;124(10):1182–1203.
105. Sola K, Brekke N, Brekke M. An activity-based intervention for obese and physically inactive children organized in primary care: feasibility and impact on fitness and BMI. Scand J Prim Health Care. 2010;28(4): 199–204.
106. Khoja SS, Susko AM, Josbeno DA, Piva SR, Fitzgerald GK. Comparing physical activity programs for managing osteoarthritis in overweight or obese patients. J Comp Eff Res. 2014;3(3):283–299.
107. Haight DJ, Lerner ZF, Borad WJ, Browning RC. A comparison of slow, uphill and fast, level walking on lower extremity biomechanics and tibiofemoral joint loading in obese and nonobese adults. J Orthop Res. 2014;32(2):324–330.
108. Miller GD, Nicklas BJ, Davis C, Loeser R F, Lenchik L, Messier S P. Intensive weight loss program improves physical function in older obese adults with knee osteoarthritis. Obesity. 2006;14(7):1219–1230.
109. Vincent HK, Vincent KR. Considerations for initiating and progressing running programs in obese individuals. PM R. 2013;5(6):513–519.