The heavy truth: how being overweight contributes to chronic pain
For many patients, there's a piece of the puzzle that often goes overlooked or feels too sensitive to address what it comes to pain management: the connection between body weight and pain levels.
According to the CDC, chronic pain—defined as pain lasting three months or longer—affects more than 50 million adults in the United States. It disrupts work, sleep and relationships. While the causes of chronic pain are complex, research increasingly shows a bidirectional relationship between excess weight and pain. Being overweight can cause or worsen pain, and being in pain can make it incredibly difficult to maintain a healthy weight.
At DFW Interventional Pain Institute, Dr. Edrick Lopez and our team believe that understanding this connection is the first step toward relief. We want to empower you with the science behind your symptoms and the modern treatments available to help you break the cycle.
The connection: weight and pain
Many people assume that the link between weight and pain is purely mechanical—that a heavier body simply pushes harder on the joints. While that's true, it's only part of the story. The relationship is actually twofold: mechanical stress and systemic inflammation.
Increased mechanical stress
Physics plays a major role in your daily comfort. Your joints, particularly your "weight-bearing" joints like the hips, knees and ankles, are responsible for supporting your body against gravity.
The force placed on your knees isn't a 1-to-1 ratio with your weight. Biomechanical studies suggest that for every pound of excess weight you carry, you place approximately four pounds of extra pressure on your knee joints when walking. This means that losing just 10 pounds can relieve 40 pounds of pressure from your knees with every step you take. Over time, this excess mechanical load accelerates the wear and tear on cartilage, leading to conditions like osteoarthritis.
Inflammation and body chemistry
This is the factor that surprises most patients. Adipose tissue (body fat) was once thought to be merely energy storage. We now know it is biologically active tissue that releases hormones and proteins.
Excess fat tissue, particularly visceral fat around the abdomen, releases pro-inflammatory chemicals known as cytokines. These chemicals circulate throughout the body, creating a state of low-grade, chronic systemic inflammation. This explains why individuals with obesity often report pain in non-weight-bearing areas, such as the hands or wrists. The inflammation sensitizes nerve endings, making your body more susceptible to pain signals.
Nerve compression
Excess weight can physically alter the way your body is aligned. Extra tissue can compress nerves or shift your center of gravity, leading to conditions like sciatica, where the sciatic nerve becomes irritated or compressed. This often results in sharp, shooting pain radiating from the lower back down the legs.
Weight-related conditions and pain
Because of the mechanical and inflammatory factors mentioned above, excess weight is a significant risk factor for several specific pain conditions.
Osteoarthritis
This is the most common form of arthritis, often described as "wear and tear." The combination of heavy load and inflammatory chemicals breaks down the cartilage that cushions the ends of your bones. While age is a factor, weight is a major accelerator.
Back pain
Your spine is designed to carry weight, but it has limits, and when they're reached it can result in chronic back pain. Excess weight, particularly in the midsection, pulls the pelvis forward, straining the lower back muscles and ligaments. This can lead to herniated discs and chronic lumbar strain.
Fibromyalgia
Studies have shown a strong correlation between obesity and fibromyalgia. While the exact mechanism is still being studied, the systemic inflammation caused by excess weight likely exacerbates the widespread sensitivity and fatigue associated with fibromyalgia.
Migraines
The link between weight and headaches is becoming clearer. Research suggests that individuals with obesity are more likely to suffer from chronic migraines than those at a healthy weight. Again, inflammatory proteins released by fat tissue may trigger the neurovascular pathways that cause migraine pain.
Practical tips for managing weight and pain
Breaking the cycle of "pain causes inactivity, inactivity causes weight gain, weight gain causes more pain" is difficult, but it is not impossible. Here are a few foundational steps to consider.
Movement is medicine
When you hurt, the last thing you want to do is move. However, safe, low-impact exercise is crucial. Activities like swimming or water aerobics take the weight off your joints while allowing you to build strength and burn calories. Walking, even for short distances, helps keep joints lubricated.
Dietary adjustments
Focus on an anti-inflammatory diet. This involves reducing processed foods and sugars, which can spike inflammation, and increasing your intake of leafy greens, fatty fish (rich in Omega-3s), nuts, and berries.
Physical therapy
A physical therapist doesn't just help you exercise; they teach you how to move correctly. They can help you strengthen the muscles surrounding your painful joints, providing an internal brace that reduces pain and improves mobility.
Treatment options at DFW Interventional Pain Institute
We know that "eat less and move more" is often not enough, especially when chronic pain limits your ability to exercise. Dr. Lopez and our team offer advanced medical interventions that tackle both the weight and the pain directly.
GLP-1 medications for weight loss
For many patients, biological factors make weight loss incredibly difficult. We offer GLP-1 receptor agonists (such as semaglutide), which have revolutionized medical weight management.
These medications mimic a natural hormone in your body that regulates appetite. They work by signaling to your brain that you are full and slowing down how fast your stomach empties. This helps you eat less without the constant battle against hunger. By helping patients achieve significant weight loss, we often see a drastic reduction in their joint pain and inflammation, making other pain treatments more effective.
Pain management treatments
Dr. Lopez is a double board-certified interventional pain management physician. We don't just treat the weight; we treat the pain source directly. This might include:
Medication management: Safe and effective pharmacological strategies to lower pain baselines.
Trigger point injections: Targeting knots in muscles that contribute to chronic tension.
Platelet-rich plasma (PRP) injections
For patients with knee osteoarthritis exacerbated by weight, PRP is a cutting-edge option. PRP therapy involves drawing a small amount of your own blood, concentrating the healing platelets and injecting them back into the injured joint. This can reduce inflammation, promote healing and delay or eliminate the need for surgery.
Botox for chronic migraines
If weight-related inflammation is triggering your migraines, we can help break the cycle with Botox injections. This FDA-approved treatment prevents the release of chemicals involved in pain transmission, offering months of relief for chronic migraine sufferers.
Breaking the cycle of pain with Dr. Lopez and our team
Living with chronic pain and struggling with weight can feel isolating, but you don't have to manage it alone. The science is clear: reducing excess weight can significantly lower pain levels, improve mobility and enhance your overall quality of life. By being aware of the symptoms and the treatments, this year could be your best year for tackling weight loss and improving pain symptoms.
At DFW Interventional Pain Institute, Dr. Lopez uses a holistic approach that combines Harvard-trained expertise with compassionate care. Whether you need help managing weight through GLP-1 medications or require interventional procedures to target joint and spine pain, we're here to help.
Living with pain isn't your only option. If you're ready to address the root causes of your discomfort, contact us today to schedule an evaluation.
