Obesity - Physical Therapists can help

The recent recognition of obesity as a disease in the US has once again focused attention on a very important health issue. Obesity has long been identified as a known risk factor for a large number and variety of health conditions, ranging from heart disease and diabetes to cancer. It is a leading cause of death in America. Obesity is also a risk factor for many musculoskeletal disorders – everything from fractures and plantar fasciitis to low back, hip and knee pain.

It is easy to understand why being overweight or obese is linked to joint and muscle pain syndromes. Excessive weight imparts a chronic stress to the joints, particularly the distal spinal and lower extremity joints, which in turn contributes to mechanical wear and tear. One of the hallmarks of knee osteoarthritis (OA), for example, is mechanical breakdown of the joint tissues. It is no surprise then that obesity is a risk factor for the development of knee OA. Unfortunately, it is one of the most overlooked, modifiable risk factors in the medical management of knee OA. Obese or overweight individuals diagnosed with knee OA should be directed early in their course of care to weight loss as a treatment approach. This should be a first priority treatment. Unfortunately, the standard of care has been the prescription of non-steroidal anti-inflammatory (NSAID) medications as a front-line measure. NSAID’s do not provide a long-term solution for OA. Long-term solutions include modification of joint loading, and improving the integrity of the joint through exercise prescription.

This logic for the treatment of knee OA can be extended to many other musculoskeletal conditions. Although it may not always be a first priority intervention, it often does play a role in the overall management of many orthopedic conditions in obese individuals. Physical therapists are among the health care professionals that can provide more information on this topic.

Marcia Miller Spoto, PT, DC, OCS