Abstract

BackgroundThe association between overweight and chronic musculoskeletal pain may vary by anatomical site and be modified by hypertension status. This study examined the associations between overweight and low back and knee pains and their effect modification by hypertension status.MethodsWe conducted a community-based cross-sectional study involving 2,845 adults (1,080 men and 1,765 women) aged 40–89 years. Chronic knee pain (CKP) and low back pain (CLBP) lasting more than 3 months were categorized into more or less severe pain. Odds ratios (ORs) and 95% confidence intervals (CIs) of the association between overweight and more or less severe CKP and CLBP were determined using logistic regression and stratified by hypertension status. Adjustment variables were age, sex, area, hypertension, smoking and drinking status, inactivity, job category, mental stress, depression, and overall CKP or CLBP.ResultsOverall, 288 (10.1%) and 631 (22.2%) adults had more and less severe CKP, respectively, and 284 (10.0%) and 830 (29.2%) had more and less severe CLBP, respectively. Overweight was associated with overall CKP and more or less severe CKP, regardless of hypertension status. Overweight was not associated with overall CLBP; its association was more pronounced for more severe CLBP. The association between overweight and more severe CLBP was evident among non-hypertensives (multivariable OR 1.72; 95% CI, 1.09–2.71); however, that between overweight and less severe CLBP was not evident (multivariable OR 1.07; 95% CI, 0.73–1.56).ConclusionsAs hypertension may attenuate the association between overweight and CLBP, we should consider hypertension status for proper management of CLBP among overweight individuals.

Highlights

  • Chronic musculoskeletal pain, represented by chronic knee pain (CKP) and chronic low back pain (CLBP), likely reduces social participation and activities of daily living.[1,2] Overweight, defined as body mass index (BMI) of ≥25 kg=m2, has been considered to be associated with Chronic knee pain (CKP) and CLBP.[3,4,5,6,7] A meta-analysis reported a positive association between overweight and CLBP; pooled odds ratio (OR) was 1.33 (95% confidence interval [confidence intervals (CIs)], 1.14–1.56),[8] but did not examine the severity of CLBP

  • There was no effect-modifications by age group (40–59 years and 60–89 years) for the association between hypertension and CLBP or CKP (P for interaction 0.76 for CKP, 0.95 for CLBP, not shown in Table)

  • The interaction for the association between overweight and more severe CLBP by hypertensive status was statistically significant (P for interaction = 0.046). In this community-based cross-sectional study, overweight showed a significant positive association with overall CKP even after adjustment for overall CLBP, the association was stronger for more severe CKP than for less severe CKP

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Summary

Introduction

Chronic musculoskeletal pain, represented by chronic knee pain (CKP) and chronic low back pain (CLBP), likely reduces social participation and activities of daily living.[1,2] Overweight, defined as body mass index (BMI) of ≥25 kg=m2, has been considered to be associated with CKP and CLBP.[3,4,5,6,7] A meta-analysis reported a positive association between overweight and CLBP; pooled odds ratio (OR) was 1.33 (95% confidence interval [CI], 1.14–1.56),[8] but did not examine the severity of CLBP. Previous studies investigated the association between overweight and knee or low back pain separately, without taking into consideration the coexistence of knee and low back pain, they often coincide.[9,10]. The association between overweight and chronic musculoskeletal pain may vary by anatomical site and be modified by hypertension status. This study examined the associations between overweight and low back and knee pains and their effect modification by hypertension status

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