Losing Weight as a Treatment for Chronic Pain – Jenny L. F. Andrus, MD

As an Interventional Pain Management Specialist, I see patients in my practice who report suffering from chronic pain caused by a variety of diseases or injuries. Often times, we discuss many different methods of treating the pain, ranging from the use of non-narcotic medications to very potent opioid drugs, lifestyle changes, Physical Therapy, interventional procedures and even surgery. For some patients, these approaches are necessary and appropriate. But for some patients, weight loss could provide the most effective and long-lasting form of pain relief. In this article, I will discuss the use of weight loss as a pain reliever for several conditions.
Why does carrying excess weight cause or exacerbate pain?
When a person gains weight, the musculoskeletal system of the body must compensate to carry the extra pounds. The muscles and ligaments become more stressed, the spine can be pulled out of alignment and joints can become sore. Over time, this extra weight may accelerate the development of joint degeneration. A person who finds movement painful tends to become less active and gain more weight. As a result, the overweight person can become obese and develop chronic musculoskeletal pain from inactivity and increased stress on their body.
What types of pain or conditions does being overweight worsen or contribute to?
1. Back Pain
a. Sciatica
b. Bulging or Herniated Disc
2. Joint Pain (Hip, Knee, Ankle, Foot)
3. Muscle Pain
4. Degenerative Disc Disease
5. Osteo, Rheumatoid or Psoriatic Arthritis
6. Diabetes/Diabetic Neuropathy
7. Fibromyalgia

What does losing weight do to relieve pain and stress on the body?
For every 1 lb. of weight you carry, your knees carry 4 lbs. and your hips carry 8 lbs. If you are significantly overweight, your joints really suffer.
Have you ever carried a very heavy bag of groceries or piece of furniture up a flight of stairs? Do you remember how good it felt when you were able to put that heavy load down? That relief is how your body feels when you lose weight. Your spine, bones, joints and muscles are relieved of so much stress and pressure. Many patients who lose weight report that their pain goes away completely, something that may never have happened with medication or surgery.
Taking narcotics for pain relief can have bad side-effects, such as constipation, drowsiness, increased sensitivity to pain, and addiction. Surgical interventions have risks and complications to consider and may be expensive and cause you to miss a lot of time from work and your family. Losing a sensible amount of weight usually has a ton of benefits and no downside, except that you might need to buy a new wardrobe!
If losing weight was so easy, everyone would do it. What suggestions do you have for patients that want to lose weight, but find it difficult to do so?
Losing weight is hard work for everyone, not only chronic pain patients. It takes determination and dedication to a lifestyle of healthy eating and exercise. There is no magic bullet…everyone is different, but you must burn more calories than you eat. It really is that simple.
If you hate the gym, find an exercise you enjoy and do it at home. If you like being with people, take a fun dance class. If you have pain when you move, find an activity where your pain is kept to a minimum. Good ones to try – swimming, biking, yoga, walking, or kayaking.
Track what you eat. Everyone thinks that they don’t eat many calories until they start tracking it. Simply cutting out a nighttime snack can make a big difference. Quit eating processed foods, junk foods and drinking sodas. Read, talk to people, go on the Internet, and watch TV shows to learn more about fitness and nutrition. Make one or two changes a week and soon you will see big progress. Ultimately you are the one responsible for your success. Though difficult to do, losing weight is worth the extra effort.
Why is weight-loss as a treatment option seldom talked about with patients?
I believe it is a combination of things…in today’s society, physicians sometimes find it difficult to talk about weight because we are afraid of hurting the patient’s feelings or making them uncomfortable. Also, patients often tell us that they don’t want to wait for weeks or months for a remedy for their pain, they want it to go away NOW, and want a prescription for a pain-relieving medication. Weight-loss takes time, patience and effort and many patients are not willing to wait.
What do you think can be done to change the mindset of those folks?
I hope that through education, we can help chronic pain patients understand that their PM physicians want to help them function better in ALL areas of their life, not in just relieving them of their pain. Losing weight offers so many benefits to the overweight/obese patient that I believe it should be a part of any comprehensive treatment and wellness plan.
Jenny L. F. Andrus, MD, is a Fellowship-trained and Board-certified Interventional Pain Management Specialist who practices at Orthopaedic & Spine Center in Newport News, VA. Dr. Andrus was voted a “Top Doc” for 2014 in a survey held by Coastal Virginia Magazine. For more information on Dr. Andrus or OSC, please go to www.osc-ortho.com or call for an appointment at 757-596-1900.