What a Pain: Obesity and Chronic Knee Pain

By: 
Dr. Christopher McGowan
June 21, 2021

It is well known that being overweight can put you at higher risk of conditions such as heart disease and hypertension, but these high-profile conditions are just the tip of the iceberg. Many other conditions can arise as a result of, or be worsened by, being overweight. 

Though it doesn’t get the same attention as heart attacks or diabetes, weight related joint damage such as rheumatoid arthritis in the knees can dramatically affect your quality of life, and could even make it harder for you to maintain a healthy weight as you age. 

The Connection Between Obesity and Knee Pain

Weight management is an increasing problem for many people. More than half of American adults have a body mass index, or BMI, that puts them in the category of obesity. Having a high BMI, especially if it is paired with unusually high waist circumference or the components of metabolic syndrome, puts you at a significantly higher risk of experiencing chronic knee pain than the average population. 

Knee osteoarthritis, or knee OA, is a significant concern for people who are overweight, especially as they age. Being overweight exposes your joints to increased stress compared to those placed on the joints of people who maintain a healthy weight. Eventually, joint damage such as loss of cartilage and bone spurs can develop. 

It is important to remember not all weight is carried the same, and everyone’s body is built differently. Picking a number on the scale is not the only way to understand your chances of developing knee OA. For example, individuals diagnosed with metabolic syndrome have different rates of prevalence of joint pain and knee problems than individuals with similar weight but who carry more lean muscle mass.

Though osteoarthritis is not as immediate a concern to your life as heart disease, the impact on your quality of life and overall wellness from not being able to move can be extensive. Lowered levels of mobility are linked to less time spent outdoors and even lowered levels of social interaction in extreme cases. These limitations are linked to increased rates of depression, anxiety, and other mental health challenges, all of which are linked back to the possibility of further weight gain. 

Can Obesity Cause Joint Pain?

Obesity itself is not always the root cause of knee pain, but it can certainly make existing conditions worse, and over time can contribute to the formation of osteoarthritis. As your body weight increases, the loads your knees experience increase at a startling rate. If you are overweight, for every pound of excess weight you carry, your knees have to absorb the equivalent of as much as four pounds of pressure with each step you take. 

Your raw weight isn’t the only risk factor that obesity introduces for knee pain. Being chronically overweight is highly correlated with an elevated inflammatory response throughout your body. There is evidence to suggest that this inflammation is possibly contributory to knee joint pain rather than a consequence of it, as was previously thought.

Does Losing Weight Help Joint Pain?

Regardless of the underlying cause of your knee pain, losing weight will almost certainly provide some level of pain relief. Many of the steps you need to be successful in a weight loss program can also help improve joint health. The elements of overall wellness like eating a healthy diet, cutting stress where possible, increasing your levels of physical activity, and working to build lean muscle mass all play a role in helping to reduce joint pain. 

Relieving some of the pain you are experiencing may also allow you to be more physically active, which can help stabilize your knees, potentially further reducing your levels of pain. Hip stability can be built through even small amounts of low-impact activities. These kind of exercises can build strength in your hips, legs, and ankles to begin correcting poor knee alignment, which may contribute to pain. Musculoskeletal stability in the weight bearing joints like the knees is influenced by strength and conditioning of muscles throughout the body. 

How to Exercise if You Have Knee Pain

If being overweight is causing you joint pain, it may seem counterintuitive that moving more may help. If you are having trouble walking without pain, the thought of running may seem like torture. Thankfully there are many different ways to start exercising that are easier on your body.

You certainly need to be careful at the beginning of any exercise program, particularly if you are just beginning your weight loss journey. Careful planning, talking with your doctor, and making use of water-based activities and non-impact activities like stationary cycling can help you burn calories and begin building muscle mass without subjecting your joints to the pounding impact of running. 

Perhaps the most important factor in any exercise program is to start slowly. If you have not been working out regularly, you will need to be careful at the outset not to overdo it. Many people who start an exercise program too quickly place themselves at risk for an injury that could set back their efforts to get in shape. 

Finding exercises you can do if you have chronic knee pain or knee OA can be difficult. A few of the best exercises to get you started include the following:

  • cycling
  • swimming
  • water aerobics
  • tai chi
  • walking 
  • yoga

Weight Loss, Joint Replacement, and Weight Loss Surgery

The negative effects of obesity are wide ranging, and knee pain is far from the most serious consequence of being overweight. High blood pressure, increased risk of developing type 2 diabetes, and increased chances of cardiovascular disease are all strongly correlated with obesity. Getting a handle on your weight is crucial if you are going to lower your chances of these deadly diseases, especially as you age. 

One of the real dangers for obese people is the spiraling cycle that can arise from extra weight causing joint pain, which leads to lowered levels of physical activity, possibly leading to further weight gain. Once chronic pain in the joints sets in, it can become difficult to perform enough exercise necessary to return to a normal weight.  

The human body has an amazing ability to heal itself, but eventually, sometimes the stresses become too great. In these cases, knee replacement may have to be considered. One of the challenges for obese patients is that surgery outcomes for joint replacement are typically worse for people who are overweight. This can land you in the awkward position of needing to lose weight to be able to have a surgery that would let you be more physically active, even though you need the physical activity to help you lose the weight. 

For some people, getting the pounds off must come before serious attempts at exercise can be made. If your BMI is approaching 40, you could find yourself in a position where losing a significant amount of weight is going to be necessary. For some people, this may even mean exploring options such as a weight loss procedure to help rapidly drop weight. 

Wherever you are along the path to freedom from excess body weight, knowing the options available to you is important. If you have considered weight loss surgery, or simply feel like you need some help along the road to a healthy weight, request a consultation at True You Weight Loss today.

Dr. Christopher McGowan
Dr. Christopher McGowan
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