Does changing weight change pain? Retrospective data analysis from a national multidisciplinary weight management service. (21st May 2019)

• Record Type: Journal Article
• Authors: Dunlevy, Colin; MacLellan, Grace A.; O'Malley, Emer; Blake, Catherine; Breen, Cathy; Gaynor, Karen; Wallace, Natalie; Yoder, Ruth; Casey, Domhnall; Mehegan, John; Fullen, Brona M.; O'Shea, Donal
• Is Part Of: European journal of pain. Volume 23:Number 8(2019)
• Page Start: 1403
• Page End: 1415
• Publication Date: 2019-05-21
• Subjects: Pain -- Periodicals; Pain -- Treatment -- Periodicals; Pain -- Physiological aspects -- Periodicals; 616.0472
• DOI: 10.1002/ejp.1397
• Languages: English
• ISSNs: 1090-3801

Abstract

Abstract: Background: Musculoskeletal (MSK) pain is common in obese populations. Multidisciplinary Tier 3 weight management services (WMS) are effective in reducing weight; however, MSK pain as an outcome is not routinely reported post‐WMS interventions. Methods: Following ethical approval this retrospective design study using anonymized data from a national WMS established changes in anthropometric and pain prevalence and intensity scores as well as establishing variables predictive of achieving clinically significant changes (CSC) in pain scores. Results: Of the 806 patients registered to the WMS (January 2011–February 2015), 59% ( n = 476; CI = 56–62) attended their reassessments at 6 months. The overall mean age was 45.1 ± 12 years and 62% ( n = 294) were female. At baseline 70% ( n = 281; CI = 65–75) reported low back pain (LBP) and 59% ( n = 234; CI = 54–64) had knee pain. At reassessment 37.3% ( n = 177) of patients lost ≥5% body weight, 58.7% ( n = 279) were weight stable (5% weight loss or gain) and 4.0% ( n = 19) gained ≥5% body weight. Low back and knee pain prevalence reduced significantly for those who lost ≥5% body weight. Variables predictive of a CSC in LBP numerical rating scale (NRS) score included a higher baseline NRS score, weighing more, and rating losing weight as being important ( p < 0.05). Higher baseline NRS and being younger resulted in higher odds of a CSC in knee pain NRS ( p < 0.05). Conclusions: Overall this WMS was effective for clinical weight loss. For those who lost most weight prevalence of knee and LBP reduced. Imbedding pain management strategies within WMS's may provide a more holistic approach to obesity management. Significance: Weight loss can reduce musculoskeletal pain, particularly for those who lose more weight. Imbedding pain management strategies within these services may provide a more holistic approach to obesity management.