BACKGROUND Back and lower limb pain have a major impact on physical function and quality of life. While obesity is a modifiable risk factor for musculoskeletal pain, the role of adiposity is less clear. This systematic review aimed to examine the relationship between both adiposity and its distribution and back and lower limb pain. METHODS A systematic search of electronic databases was conducted to identify studies that examined the association between anthropometric and/or direct measures of adiposity and site specific musculoskeletal pain. Risk of bias was assessed and a best evidence synthesis was performed. RESULTS A total of 56 studies were identified which examined 4 pain regions, including the lower back (36 studies), hip (two studies), knee (13 studies) and foot (eight studies). 31(55%) studies were assessed as having low to moderate risk of bias. 17(30%) studies were cohort in design. The best evidence synthesis provided evidence of a relationship between central adiposity and low back and knee pain, but not hip or foot pain. There was also evidence of a longitudinal relationship between adiposity and the presence of back, knee and foot pain, as well as incident and increasing foot pain. CONCLUSIONS This systematic review provides evidence of an association between both body fat and its central distribution and low back and knee pain, and a longitudinal relationship between adiposity and back, knee and foot pain. These results highlight the potential for targeting adiposity in the development of novel treatments at these sites.

中文翻译：

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肥胖与背部和下肢疼痛有关吗？系统回顾。


背景技术背部和下肢疼痛对身体功能和生活质量具有重大影响。虽然肥胖是肌肉骨骼疼痛的一个可改变的危险因素，但肥胖的作用尚不清楚。本系统综述旨在探讨肥胖及其分布与背部和下肢疼痛之间的关系。方法 对电子数据库进行系统搜索，以确定研究人体测量和/或直接测量肥胖与部位特异性肌肉骨骼疼痛之间关联的研究。评估了偏倚风险并进行了最佳证据综合。结果 总共确定了 56 项研究，检查了 4 个疼痛区域，包括下背部（36 项研究）、臀部（2 项研究）、膝盖（13 项研究）和足部（8 项研究）。 31 项（55%）研究被评估为具有低至中度偏倚风险。 17（30%）项研究是队列设计。最好的证据综合提供了中心性肥胖与腰背和膝盖疼痛之间关系的证据，但与臀部或足部疼痛无关。还有证据表明，肥胖与背部、膝盖和足部疼痛以及足部疼痛的发生和加剧之间存在纵向关系。结论 这项系统评价提供了证据，证明身体脂肪及其中心分布与腰背和膝盖疼痛之间存在关联，以及肥胖与背部、膝盖和足部疼痛之间的纵向关系。这些结果凸显了在这些部位开发新疗法中针对肥胖的潜力。