203662 Effect of Obesity on Treatment Outcomes for Low Back Pain

Monday, November 9, 2009: 10:30 AM

Stanley Ewald, DC, MPH , Los Angeles College of Chiiropractic, Southern California University of Health Sciences, Whittier, CA
Eric L. Hurwitz, DC, PhD , Office of Public Health Studies, University of Hawaii, Honolulu, HI
Objectives. The objective of this study is to estimate the effect of obesity, as measured by body mass index (BMI), on treatment outcomes for low back pain.

Methods. Data from the UCLA and Friendly Hills Healthcare Network low back pain study (collected from 1995 to 2000) were used to perform a secondary data analysis of this randomized clinical trial on adults who sought care for low back pain. BMI was the primary predictor variable; pain and disability at 6 months were the outcomes. Potential confounders or modifiers included sociodemographic, lifestyle, psychological, and low back pain related variables. Binary logistic regression modeling was performed to estimate odds ratios adjusted for the effects of covariates.

Results. Using normal weight as the referent population (BMI = 19.0 to <25.0), underweight (BMI <19.0) and overweight (BMI = 25.0 to <30.0) were not associated with any of the outcome variables. However, the odds of clinically meaningful reductions in disability and most severe pain were less in the obese (BMI > 30) than in the normal weight population (disability: odds ratio [OR], 95% confidence interval [CI] 0.615 (0.379, 0.998); most severe pain: 0.550 (0.341, 0.889). Duration of the current episode of low back pain, patient's confidence that the treatment s/he will receive will be beneficial, race, smoking status, and weight gain each demonstrated a possible association with treatment outcome.

Conclusion. Obesity was found to negatively influence pain and disability outcomes among low-back-pain patients receiving chiropractic or medical care for their pain.

Learning Objectives:
Define prognostic value of BMI assessment in low back pain management.

Keywords: Obesity, Treatment Outcomes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was the primary data collector. I am the primary author and all revisions were written under the guidance of my MPH supervisor (Dr. Eric Hurwitz). I completed my MPH at UCLA graduating in 2001 and the title of my thesis was "Effect of Obesity on Treatment Outcomes for Low Back Pain." This conference will represent the first time this material has been presented.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.