Muscle composition may indicate risk of chronic back pain

Lower back pain—also known as lumbago—is the leading cause of disability worldwide, according to the World Health Organization (WHO) . In 2020, 619 million people suffered from the condition, according to the WHO. This number represents a 60% increase compared to 1990, and is expected to continue growing: cases are projected to reach 843 million individuals by 2050.

In a study published in July in the scientific journal The Lancet Regional Health – Europe , researchers from Germany sought to identify possible modifiable risk factors for the problem. Therefore, they decided to examine the link between body muscle composition and this type of pain.

The analysis, which involved more than 30,000 participants aged 19 to 74, used full-body MRI scans with artificial intelligence to map muscle composition. The scientists also considered factors that influence body composition, such as age, gender, physical activity, and the presence of comorbidities, osteoporosis, and high cholesterol.

At the end of the investigation, they concluded that higher levels of fat between the muscles of the thoracic and lumbar regions are associated with a greater likelihood of chronic low back pain. On the other hand, those with more muscle mass in this part of the body are less likely to suffer from the condition.

For orthopedic surgeon Fernando Jorge, a member of the American Society for Regenerative Medicine (ASRM) and the American Board of Regenerative Medicine, the study offers promising insights into the management of this debilitating pain. "It strongly suggests that modifiable risk factors, such as muscle composition, can be targets for prevention and treatment," he states.

But the research didn't address the effect of weight loss on the proportion of intermuscular fat, for example. Further analyses would be necessary to understand what leads to this condition. "Some important factors regarding chronic low back pain should be included in future investigations, such as psychological, nutritional, and occupational factors," suggests orthopedist Luciano Miller of Einstein Hospital Israelita. "But, even so, this is a study of paramount importance in understanding the factors related to such a prevalent disease."

According to Miller, who is also a tenured professor at the ABC School of Medicine in São Paulo, the proportion of adipose tissue in the muscles of the dorso-lumbar region is influenced by factors such as a sedentary lifestyle, aging, diet, obesity, insulin resistance, hormonal and inflammatory issues, as well as the individual's own genetics.

There's evidence that rehabilitation programs with strength training, nutritional control, and weight loss can help reduce intermuscular fat. "However, the effects are modest and slow, and depend on the intensity, regularity, and individualization of the workouts," warns the Einstein physician.

Source: Einstein Agency

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