“Reducing abdominal adiposity may be considered a target for chronic pain management, particularly in those with pain in multiple sites and widespread pain,” wrote investigators.
A study published in Regional Anesthesia & Pain Medicine found that abdominal adipose tissue was associated with chronic musculoskeletal pain, suggesting that excessive and ectopic fat depositions may be involved in the pathogenesis of multisite and widespread chronic musculoskeletal pain.1 Stronger effects observed in women than men may reflect sex differences in fat distribution and hormones, according to investigators.
Close-up view of adipocytes, which primarily compose adipose tissue / mirifadapt - stock.adobe.com
Although obesity has been linked to musculoskeletal pain, there is a paucity of research on the relationship between excessive visceral (VAT) and subcutaneous adipose tissue (SAT) and chronic pain in multiple sites and widespread chronic pain. The current study aimed to fill this gap by describing the associations between MRI-derived abdominal adipose tissue and multisite and widespread chronic musculoskeletal pain.
Incorporate these strategies into your pharmacy practice to improve patient outcomes.
A total of 32,409 participants were enrolled from the UK BioBank study, a large, prospective, population-based cohort study focused on improving the prevention, diagnosis, and treatment of a wide range of serious and life-threatening illnesses.
Abdominal MRI scans were performed at 2 imaging visits to quantify VAT and SAT. At corresponding visits, participants were asked to report any pain in the last month that interfered with their regular activities. If they experienced pain, they were asked to specify whether it was in the neck or shoulder, back, hip, knee, or all over the body.
Respondents were then categorized into 6 groups: no chronic pain; chronic pain in 1, 2, 3 or 4 sites; and those with chronic pain all over the body. Further, participants were categorized into those experiencing chronic pain and those without. Chronic pain was defined as having pain that lasted more than 3 months.
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In multivariable analyses, investigators observed a dose-response association of VAT, SAT, and their ratio with the number of chronic pain sites in both women (VAT: OR 2.04 per SD [95% CI 1.85 to 2.26]; SAT: OR 1.60 [95% CI 1.50 to 1.70]; and their ratio: OR 1.60 [95% CI 1.37 to 1.87]) and men (VAT: OR 1.34 [95% CI 1.26 to 1.42]; SAT: OR 1.39 [95% CI 1.29 to 1.49]; and their ratio: OR 1.13 [95% CI 1.07 to 1.20]). Notably, the association was stronger between adipose tissue and chronic pain in women compared to men.
Additionally, people with more VAT, SAT, a greater ratio of VAT to SAT, and BMI were more likely to report chronic pain, regardless of their gender. This remained true even after adjusting for age, heigh, ethnicity, house income, highest education level, alcohol frequency, smoking status, physical activity, comorbid conditions, sleep duration, psychological problems, and follow-up time.
“Reducing abdominal adiposity may be considered a target for chronic pain management, particularly in those with pain in multiple sites and widespread pain,” wrote investigators.1
Worldwide adult obesity has more than doubled since 1990,2 and obesity represents a complex public health issue. Numerous studies have associated overweight and obesity with numerous chronic diseases, including musculoskeletal pain, which can reduce quality of life and physical function.1
Multisite musculoskeletal pain, which describes pain affecting 2 or more body parts, is more common than single-site pain.1 Previous studies, including those conducted by the current investigators, have demonstrated that a large percentage of middle-aged and older adults ranging from 41% to 75% experience this condition.3,4
Current findings lend important insights to pharmacists in providing weight loss and pain management counseling. By addressing medication-related side effects that may cause weight gain and exacerbate pain, promoting healthy lifestyle changes that contribute jointly to weight loss and pain relief, and referring patients to specialists, such as dietitians, for further support and treatment, these health care professionals can play a crucial role in helping individuals manage both obesity and pain.5
READ MORE: Pain Management Resource Center
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