Disk degeneration and low back pain: are they fat-related conditions?
Low back pain (LBP) is the world's most debilitating condition. Disk degeneration has been regarded as a strong determinant associated with LBP. Overweight and obesity are public health concerns that affect every population worldwide and whose prevalence continues to rise. Studies have indicated strong associations between overweight/obesity and disk degeneration as well as with LBP. This broad narrative review article addresses the various mechanisms that may be involved leading to disk degeneration and/or LBP in the setting of overweight/obesity. In particular, our goal is to raise awareness of the role of fat cells and their involvement via altered metabolism or the release of adipokines as well as other pathways that may lead to the development of disk degeneration and LBP. Understanding the role of fat in this process may aid in the development of novel biological therapies and technologies to halt the progression or regenerate the disk. Moreover, with genetic advancements and the appreciation of genetic epidemiology, a more personalized approach to spine care may have to consider the role of fat in any preventative, therapeutic, and/or prognosis modalities toward the disk and LBP.
Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, SAR, China.
Dino
D
Samartzis
Department of Physical and Rehabilitation Medicine, Institute of Clinical Medicine, University of Oulu, and Medical Research Center Oulu, Oulu, Finland.
Jaro
J
Karppinen
Department of Orthopaedics and Traumatology, University of Hong Kong, Hong Kong, SAR, China.
Jason Pui Yin
JP
Cheung
Department of Orthopaedic Surgery, University of California at San Francisco, San Francisco, California, United States.
Jeffrey
J
Lotz
adipokines; disk degeneration; fat; low back pain; metabolism; obesity; spine