The association between body fat and musculoskeletal pain: a systematic review and meta-analysis

dc.contributor.author Walsh, Tom P
dc.contributor.author Arnold, John B
dc.contributor.author Evans, Angela M
dc.contributor.author Yaxley, Alison
dc.contributor.author Damarell, Raechel
dc.contributor.author Shanahan, Ernst Michael
dc.date.accessioned 2018-08-16T03:30:58Z
dc.date.available 2018-08-16T03:30:58Z
dc.date.issued 2018-07-18
dc.date.updated 2018-07-20T03:59:29Z
dc.description © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
dc.description.abstract Background Obesity and musculoskeletal pain are strongly related, but there is emerging evidence that body fat, not body weight, may be a better indicator of risk. There is, therefore, a need to determine if body fat is associated with musculoskeletal pain as it may improve management strategies. The aim of this systematic review was to investigate the association between body fat and musculoskeletal pain. Methods Seven electronic databases were searched from inception to 8th January 2018. Cross-sectional and longitudinal studies investigating the association between measures of body fat and musculoskeletal pain were included. All included articles were assessed for methodological rigour using the Epidemiology Appraisal Instrument. Standardised mean differences (SMDs) and effect estimates were pooled for meta-analysis. Results A total of 10,221 citations were identified through the database searching, which after abstract and full-text review, yielded 28 unique articles. Fourteen studies were included in the meta-analyses, which found significant cross-sectional associations between total body fat mass and widespread pain (SMD 0.49, 95% CI 0.37–0.61, p < 0.001). Individuals with low-back pain and knee pain had a higher body fat percentage than asymptomatic controls (SMD 0.34, 95% CI 0.17–0.52, p < 0.001 and SMD 0.18, 95% CI 0.05–0.32, p = 0.009, respectively). Fat mass index was significantly, albeit weakly, associated with foot pain (SMD 0.05, 95% CI 0.03–0.06, p < 0.001). Longitudinal studies (n = 8) were unsuitable for meta-analysis, but were largely indicative of elevated body fat increasing the risk of incident and worsening joint pain. There was conflicting evidence for an association between body fat percentage and incident low-back pain (3 studies, follow-up 4–20 years). Increasing knee pain (1 study) and incident foot pain (2 studies) were positively associated with body fat percentage and fat mass index. The percentage of items in the EAI graded as ‘yes’ for each study ranged from 23 to 85%, indicating variable methodological quality of the included studies. Conclusions This systematic review and meta-analysis identified positive cross-sectional associations between increased body fat and widespread and single-site joint pain in the low-back, knee and foot. Longitudinal studies suggest elevated body fat may infer increased risk of incident and worsening joint pain, although further high-quality studies are required. en_US
dc.description.sponsorship TPW is funded by a Nursing and Allied Health Scholarship and Support Scheme funded by the Commonwealth Department of Health and administered by Services for Australian Rural and Remote Allied Health. JBA is currently supported by a National Health and Medical Research Council Early Career Research Fellowship (ID: 1120560). en_US
dc.identifier.citation Walsh, T. P., Arnold, J. B., Evans, A.M., Yaxley, A., Damarell, R., & Shanahan, E.M., (2018). The association between body fat and musculoskeletal pain: a systematic review and meta-analysis. BMC Musculoskeletal Disorders, 19(1):233.
dc.identifier.doi https://doi.org/10.1186/s12891-018-2137-0
dc.identifier.issn 1471-2474
dc.identifier.uri http://hdl.handle.net/2328/38187
dc.language.iso en en
dc.publisher BioMed Central
dc.relation http://purl.org/au-research/grants/nhmrc/1120560 en
dc.relation.grantnumber NHMRC/1120560 en
dc.rights © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/ ), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
dc.rights.holder The Author(s).
dc.rights.license CC-BY
dc.subject Obesity
dc.subject Body composition
dc.subject Musculoskeletal
dc.subject Pain
dc.subject Adiposity
dc.title The association between body fat and musculoskeletal pain: a systematic review and meta-analysis
dc.type Article en
local.contributor.authorOrcidLookup Yaxley, Alison: https://orcid.org/0000-0001-9808-4748 en_US
local.contributor.authorOrcidLookup Damarell, Raechel: http://orcid.org/0000-0002-6737-7537
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