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Title	Weight Reduction as an Intervention for Low Back Pain: Systematic Review and Implications for Physical Therapy Practice
Creator	Woolner, Jodie E.
Date Issued	2012-08
Description	Study Purpose: To review the most current literature on treatment interventions for low back pain and determine if weight management is among the interventions used. Background and Significance: Low back pain is the number two reason Americans see their healthcare professional –second only to colds and flu. Low back pain is defined as, “acute or chronic pain in the lumbar or sacral regions, which may be associated with musculo-­ligamentous sprains and strains; intervertebral disk displacement; and other conditions”. Unhealthy lifestyle behaviours are primary contributors to the prevalence of lifestyle-­related conditions, including low back pain, this century. New theories suggest weight loss may reduce the harmful effects of added load on the spine that cause altered biomechanics and increased potential for early degeneration. Current treatment for low back pain does not involve the use of weight management as an intervention. MPT Systematic Reviews and Research Projects.
Genre	Graduating Project
Type	Text
Language	eng
Series	University of British Columbia. RSPT 572
Date Available	2012-09-18
Provider	Vancouver : University of British Columbia Library
Rights	Attribution-NonCommercial-NoDerivatives 4.0 International
DOI	10.14288/1.0075707
URI	http://hdl.handle.net/2429/43218
Affiliation	Medicine, Faculty of Physical Therapy, Department of
Campus	UBCV
Peer Review Status	Unreviewed
Scholarly Level	Graduate
Rights URI	http://creativecommons.org/licenses/by-nc-nd/4.0/
AggregatedSourceRepository	DSpace

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Weight	
  Reduc,on	
  as	
  an	
  Interven,on	
  for	
  Low	
  Back	
  Pain:	
  	
   Systema,c	
  Review	
  and	
  Implica,ons	
  for	
  Physical	
  Therapy	
  Prac,ce	
  	
   Jodie	
  E.	
  Woolner,	
  	
  MPT	
  candicate1	
  Elizabeth	
  Dean,	
  PhD1	
  (Supervisor)	
   1	
  Department	
  of	
  Physical	
  Therapy,	
  University	
  of	
  Bri,sh	
  Columbia,	
  Vancouver	
  B.C.	
  Canada	
   STUDY	
  PURPOSE	
   REFERENCES	
   DISCUSSION	
  AND	
  IMPLICATIONS	
   RESULTS	
   BACKGROUND	
  AND	
  SIGNIFICANCE	
   STUDY	
  DESIGN	
  AND	
  METHODS	
   • Low	
  back	
  pain	
  is	
  the	
  number	
  two	
  reason	
  Americans	
  see	
   their	
  healthcare	
  professional	
  –	
  second	
  only	
  to	
  colds	
  and	
   flu1.	
   • Low	
  back	
  pain	
  is	
  defined	
  as,	
  “acute	
  or	
  chronic	
  pain	
  in	
  the	
   lumbar	
  or	
  sacral	
  regions,	
  which	
  may	
  be	
  associated	
  with	
   musculo-­‐ligamentous	
  sprains	
  and	
  strains;	
  intervertebral	
   disk	
  displacement;	
  and	
  other	
  condiCons”2.	
   • Unhealthy	
  lifestyle	
  behaviours	
  are	
  primary	
  contributors	
   to	
  the	
  prevalence	
  of	
  lifestyle-­‐related	
  condiCons,	
  including	
   low	
  back	
  pain,	
  this	
  century5	
   • New	
  theories	
  suggest	
  weight	
  loss	
  may	
  reduce	
  the	
   harmful	
  effects	
  of	
  added	
  load	
  on	
  the	
  spine	
  that	
  cause	
   altered	
  biomechanics	
  and	
  increased	
  potenCal	
  for	
  early	
   degeneraCon3.	
  	
   • Current	
  treatment	
  for	
  low	
  back	
  pain	
  does	
  not	
  involve	
  the	
   use	
  of	
  weight	
  management	
  as	
  an	
  intervenCon4.	
   To	
  review	
  the	
  most	
  current	
  literature	
  on	
  treatment	
   intervenCons	
  for	
  low	
  back	
  pain	
  and	
  determine	
  if	
  weight	
   management	
  is	
  among	
  the	
  intervenCons	
  used.	
  	
   DATA	
  ABSTRACTION	
  TABLE	
   • SystemaCc	
  Review	
   • MeSH	
  terms	
  used	
  in	
  EMBASE	
   • Limited	
  to	
  RCT,	
  human,	
  English,	
  past	
  year	
  (June	
   2011-­‐2012)	
   • Hand	
  exclusion	
  of	
  unrelated	
  arCcles	
  based	
  on	
  Ctle	
  and	
   abstract.	
   1A.D.A.M.	
  Medical	
  Encyclopedia	
  [Internet].	
  Atlanta	
  (GA):	
  A.D.A.M.,	
  Inc.;	
  ©2005.	
  Nail	
  abnormaliCes;	
  [updated	
  2012	
  May	
  18;	
  cited	
   2012	
  August	
  10].	
  Available	
  from:	
  hap://www.nlm.nih.gov/medlineplus/ency/arCcle/003247.htm	
   2PubMed	
  [Internet].	
  Bethesda	
  (MD):	
  NaConal	
  Library	
  of	
  Medicine	
  (US),	
  [cited	
  2012	
  August	
  10].	
  Available	
  from:	
   hap://www.ncbi.nlm.nih.gov/mesh?term=back%20pain.	
   3Wai	
  	
  EK.,	
  Rodriguez	
  S,	
  Dagenais	
  S,	
  Hall	
  H.	
  2008.	
  Evidence-­‐informed	
  management	
  of	
  chronic	
  low	
  back	
  pain	
  with	
  physical	
  acCvity,	
   smoking	
  cessaCon,	
  and	
  weight	
  loss.	
  The	
  Spine	
  Journal.	
  8.	
  195-­‐202.	
  	
   4Van	
  Middelkoop	
  M,	
  Rubinstein	
  S,	
  Kuijpers	
  T,	
  Verhagen	
  A,	
  Ostelo	
  R,	
  Koes	
  B,	
  Van	
  Tulder	
  M.	
  (2011).	
  A	
  systemaCc	
  review	
  on	
  the	
   effecCveness	
  of	
  physical	
  and	
  rehabilitaCon	
  intervenCons	
  for	
  chronic	
  non-­‐specific	
  low	
  back.	
  European	
  Spine	
  Journal.	
  20:19-­‐39	
   5Alexander	
  J,	
  Bambury	
  E,	
  Mendoza	
  A,	
  Reynolds	
  J,	
  Veronneau	
  R,	
  Dean	
  E.	
  (2011)	
  Health	
  educaCon	
  strategies	
  used	
  by	
  physical	
   therapists	
  to	
  promote	
  behaviour	
  change	
  in	
  people	
  with	
  lifestyle-­‐related	
  condiCons:	
  A	
  systemaCc	
  review.	
  Hong	
  Kong	
  Physiotherapy	
   Journal	
  (In	
  press)	
   • Weight	
  is	
  ooen	
  measured	
  as	
  a	
  baseline	
  outcome	
  of	
   research	
  but	
  is	
  not	
  followed	
  up	
  with	
  or	
  used	
  as	
  a	
   treatment	
  intervenCon.	
   • Physiotherapists	
  should	
  work	
  to	
  effect	
  long-­‐term	
  lifestyle	
   behaviour	
  change	
  to	
  improve	
  health	
  and	
  physical	
  therapy	
   outcomes6.	
  	
   • Weight	
  management	
  should	
  be	
  considered	
  a	
  first-­‐line	
   intervenCon	
  for	
  low	
  back	
  pain.	
   • More	
  research	
  into	
  the	
  effecCveness	
  of	
  physiotherapists	
   addressing	
  weight	
  management	
  as	
  an	
  intervenCon	
  for	
  low	
   back	
  pain	
  is	
  required.	
  

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