Media

HKU Finds Overweight and Obesity Significantly Increase the Risk of Spinal Disc Degeneration and Low Back Pain in Adolescents

04 May 2011

Low back pain affects every population worldwide, and is a leading cause of ill-health and sick leave in the working population of Hong Kong. One of the major causes of low back pain is degeneration of the joints of the spine, known as the intervertebral discs. The Department of Orthopaedics & Traumatology at The University of Hong Kong Li Ka Shing Faculty of Medicine has found that disc degeneration is not just a condition that develops in the elderly, but also occurs in adolescents.

Importantly, being overweight in adolescence triples the likelihood of having disc degeneration and developing more severe forms of the condition than if one was of normal weight. These findings are of public health concern and were published in the latest issue of the authoritative Journal of Bone and Joint Surgery (American Edition).

About the study
The findings of the study are based on the Hong Kong Degenerative Disc Disease Cohort, which currently consists of over 3,500 population-based Southern Chinese volunteers from the ages of 10 to 80 years of age. This is the largest programme of its kind in the world, and is supported by the University Grants Committee's Area of Excellence award on "Developmental Genomics and Skeletal Research".

The current study was a cross-sectional assessment of adolescents from this cohort who were 13-20 years of age. After taking into account the exclusion criteria, a total of 83 individuals were assessed. Among them, 65% (n=54) did not have disc degeneration while 35% (n=29) had. The majority (93%) of adolescents with disc degeneration experienced low back pain. In addition, such individuals with disc degeneration also reported a greater degree of low back pain severity and decreased physical function.

Implications and suggestions
Overweight and obesity are pandemic conditions, currently on the rise in Hong Kong and in particular in children and adolescents. According to the Department of Health, as many as 20.4% of school aged children (6 to 18 years old) in Hong Kong were overweight or obese in 2008/09. The development of disc degeneration in young age may potentially contribute to a greater severity of disc degeneration early on in life and possibly a life-time of low back pain episodes. Low back pain may potentially affect daily function, diminish the quality of life, contribute to lost wages and productivity, increase health-care costs, and lead to psychological distress. As such, preventative measures should be considered to avoid early-onset disc degeneration that may have negative physical, socioeconomic, and health-care implications affecting younger generations worldwide.

Preventive measures should start early on in life and should involve establishing a healthy diet and physical activity habits. Enjoyment and parental participation are contributing factors for physical activity participation and long-term adherence. Leading by example and becoming an active parent increases the likelihood that the children will engage in physical activity. When making activity choices for children, it is important to choose an activity that is fun and enjoyable.

The Institute of Human Performance (IHP) of the University of Hong Kong has considerable experience in helping overweight children to control weight. They suggest that children and adolescents who are already overweight or are suffering from obesity-related illnesses may be limited in the amount and intensity of activity participation they can tolerate, so one should begin with low-intensity physical activities such as walking. Activity-enhanced video games that involve significant player effort is an active alternative that seems to be particularly enjoyable. These provide mostly low to moderate intensity physical activity and are a great place to start becoming physically active.

About the research team
This study was conducted by Dr. Dino Samartzis, Professor Kenneth CHEUNG Man-chee, Professor Keith LUK Dip-kei, and Miss Florence MOK Pik-Sze from the Department of Orthopaedics and Traumatology, The University of Hong Kong Li Ka Shing Faculty of Medicine in collaboration with Dr. Daniel FONG Yee-Tak from the School of Nursing, The University of Hong Kong and Professor Jaro Karppinen from the Institute of Clinical Sciences at the University of Oulu, Oulu, Finland.

For news photos and PowerPoint slides, please visit the website at:
 http://www.med.hku.hk/v1/news-and-events/press-releases/

(From left) Dr. Dino SAMARTZIS, Research Assistant Professor, Department of Orthopaedics & Traumatology, The University of Hong Kong Li Ka Shing Faculty of Medicine; Professor Kenneth CHEUNG Man-chee, Clinical Professor, Department of Orthopaedics & Traumatology, The University of Hong Kong Li Ka Shing Faculty of Medicine; Dr. Robin MELLECKER, Post Doctoral Fellow, Institute of Human Performance, The University of Hong Kong

Professor Kenneth CHEUNG Man-chee, Clinical Professor of the Department of Orthopaedics & Traumatology, The University of Hong Kong Li Ka Shing Faculty of Medicine, says that being overweight in adolescence triples the likelihood of having disc degeneration and developing more sever forms of the condition than if one was of normal weight.

Dr. Dino SAMARTZIS, Research Assistant Professor of the Department of Orthopaedics & Traumatology, The University of Hong Kong Li Ka Shing Faculty of Medicine, points out that the majority of adolescents with disc degeneration experienced low back pain.

Dr. Robin MELLECKER, Post Doctoral Fellow of Institute of Human Performance, The University of Hong Kong, states that to prevent children from being overweight, measures should be started early on in life and should involve establishing a healthy diet and physical activity habits.