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Relationship Between Low Back Pain and Metabolic Syndrome in Japanese Adults

Is there a link between metabolic syndrome and low back pain? Any condition that can reduce or restrict physical activity has the potential to contribute to weight gain, diabetes, and low back pain. In this study from Japan, researchers investigate the relationship and prevalence between metabolic syndrome and low back pain.

Metabolic syndrome is a combination of medical disorders that, when occurring together, increase the risk of developing cardiovascular disease and diabetes. Different groups (e.g., American Heart Association, International Diabetes Federation, National Cholesterol Education Program) have varied criteria to define metabolic syndrome. Most at least include these three: 1) raised blood pressure, 2) central obesity (increased waist circumference), and 3) abnormal cholesterol levels.

Residents from two cities in Japan between the ages of 40 and 74 were included in the study. Anyone in the group of 2,650 people who reported low back pain lasting more than 24 hours or severe enough to seek medical help were placed in a group for analysis. The low back pain group was then compared to the group of individuals who did not report any low back pain.

The researchers collected many pieces of information about each person in the study to use when analyzing risk factors for low back pain. Body mass index, smoking status, alcohol use, general health, and level of physical activity were included. Sex (male or female), occupation, and a test for depression were additional bits of data collected.

Statistical analysis showed that obese women with metabolic syndrome were more likely to develop low back pain compared with obese men with metabolic syndrome. This difference looked more like a tendency toward low back pain among women than a significant trend.

Why the difference between men and women? Scientists suspect female-specific hormones and menopausal status have something to do with it. Women who are postmenopausal are also older, have reduced estrogen levels, and elevated blood pressure. Lower estrogen levels also contribute to decreased bone density, which in turn, can lead to low back pain.

The authors couldn't say for sure that low back pain is a factor that leads to the development of metabolic syndrome. Nor could they prove the opposite: that metabolic syndrome leads to low back pain. Their study does show that metabolic syndrome occurred more often in the women in their study who did have low back pain.

They conclude that women who have low back pain should be evaluated for the presence of metabolic syndrome. Treatment to address the metabolic problems may contribute to protecting and restoring normal musculoskeletal function among Japanese adult women.


Rei Ono, MPH, et al. Gender Difference in Association Between Low Back Pain and Metabolic Syndrome. In Spine. June 1, 2012. Vol. 37. No. 13. Pp. 1130-1137.

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