Association between pain intensity and body composition in adults with chronic non-specific low back pain: A systematic review and meta-analysis

Melanie Liechti; Massimo Menegon; Alexander Philipp Schurz; Jan Taeymans; Heiner Baur; Ron Clijsen; Anneleen Malfliet; Nathanael Lutz

doi:10.1111/obr.13875

Association between pain intensity and body composition in adults with chronic non-specific low back pain: A systematic review and meta-analysis

Obes Rev. 2024 Dec 2:e13875. doi: 10.1111/obr.13875. Online ahead of print.

Authors

Melanie Liechti^{1

2

3}, Massimo Menegon¹, Alexander Philipp Schurz^{1

2

3

4}, Jan Taeymans^{1

2}, Heiner Baur¹, Ron Clijsen^{1

2

5

6}, Anneleen Malfliet^{3

7

8

9}, Nathanael Lutz^{1

2}

Affiliations

¹ School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
² Department of Movement and Sport Sciences, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
³ Pain in Motion Research Group (PAIN), Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.
⁴ Faculty of Medicine, University of Bern, Bern, Switzerland.
⁵ Rehabilitation and Exercise Science Laboratory (RESLab), Department of Business Economics, Health, and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Landquart/Manno, Switzerland.
⁶ International University of Applied Sciences THIM, Landquart, Switzerland.
⁷ Research Foundation - Flanders (FWO), Brussels, Belgium.
⁸ Chronic Pain Rehabilitation, Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium.
⁹ Pain in Motion International Research Consortium, Brussels, Belgium.

PMID: 39622629
DOI: 10.1111/obr.13875

Abstract

Introduction: This systematic review and meta-analysis evaluated the association between pain intensity and different body composition measures in adults suffering from chronic non-specific low back pain (CNLBP).

Methods: A systematic literature search across five databases-PubMed, Embase, CINAHL, Web of Science, and the Cochrane Library-was conducted. It identified observational studies published until January 2024. A meta-analysis was conducted incorporating a random-effects approach with Fisher's Z transformation. A critical appraisal of the included studies' quality was conducted.

Results: Twenty-two studies were included. Of those, 20 were meta-analyzed, revealing positive, very weak correlations between pain intensity and body mass index (r = 0.11; 95% CI: 0.04 to 0.18), waist-hip ratio (r = 0.10; 95% CI: -0.14 to 0.34) and waist circumference (r = 0.09; 95% CI: -0.28 to 0.44). Not pooled study findings (e.g., hip circumference and body fat percentage) were narratively summarized, revealing 13 positive and four negative associations between pain intensity and body composition measures. Studies showed a substantial risk of bias due to unadjusted confounding factors and limited transferability of findings.

Conclusion: This systematic review and meta-analysis provided very low-quality evidence for a positive, very weak association between pain intensity and body composition measures in adults with overweight and obesity suffering from CNLBP. The included studies had a substantial risk of bias due to their observational and cross-sectional study designs, which prevents recommendations for clinical practice. Randomized controlled trials are needed to investigate the causal effect of interventions on body composition measures and pain intensity.

Keywords: back pain; body composition; overweight; pain intensity.

Publication types

Review