A recent systematic
review and meta-analysis enlightens a significant connection between increased
body fat and musculoskeletal pain. As per the analysis, it is not body weight
but the body fat which is associated strongly with pain occurrence. A total of
seven electronic databases (Web of Science, PubMed, CINAHL, Medline, Scopus,
Embase and Cochrane Central Register of Controlled Trials) till 8th Jan
2018. Overall, 10,221 citations were
found through search. Out of which only 28 unique articles were selected after
evaluating the abstract and full-text review.
The longitudinal and cross-sectional studies involved the association
between musculoskeletal pain and body fat. The methodological rigour of
articles was assessed via Epidemiology Appraisal Instrument. The Standardised
mean differences (SMDs) and effect estimates were also evaluated for
meta-analyses.
A total of fourteen studies which exhibited significant cross-sectional
relationship (SMD 0.49) of widespread pain with total body fat mass were
involved in the meta-analyses (p < 0.001). Higher body fat percentage was
seen among persons having knee (SMD 0.18) and low back pain (SMD 0.34). Foot
pain also showed a weak (SMD 0.05) but significant relationship with fat mass
index (p < 0.001). A total of 8 longitudinal studies assessed were
unsuitable for meta-analyses but provide considerable evidence of high body fat
relations with increased and worse joint pain risk. The evidence found of low
back pain and body fat associations in the follow up of 4 to 20 years were
showed specific conflicts. However, the positive relationship was seen in body
fat percentage and fat mass index with increased foot and knee pain incidences.
The variable methodological quality of involved studies was evaluated through
EAI grade as 'yes' for each study ranged from 23 to 85%.
The single-site and
widespread foot, knee and low back joint pain shows a positive correlation with
increased body fat. As per results, raised body fat relates with elevated
worsening of pain. More high-quality studies are needed for further evaluation.
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