Many severely obese adolescents who underwent bariatric surgery in the Teen-LABS study experienced musculoskeletal pain that restricted physical function and affected quality of life, according to data published in JAMA Pediatrics.
Childhood obesity is associated with many comorbidities, including diabetes, cardiovascular disease (CVD) and sleep apnea, as well as musculoskeletal pain, but data assessing the link between this pain and functional status or quality of life are limited, researchers noted in the study.
To learn more about the prevalence, sites and intensity of musculoskeletal pain in adolescents with severe obesity, the researchers evaluated data from the prospective, observational Teen-Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study.
The study collects standardized data on adolescents undergoing weight-loss surgery at five centers in the United States. The researchers examined baseline data on 233 participants from Feb. 28, 2007, to Dec. 30, 2011.
Musculoskeletal pain and pain intensity of the lower back, hips, knees and ankle or feet were evaluated using the visual analog scale. Pain was categorized as lower back pain, lower extremity pain, which included pain in the hips, knees and feet or ankles, and no pain. The Health Assessment Questionnaire Disability Index was used to assess self-reported physical function status and the Weight on Quality of Life–Kids was used to assess weight-related quality of life.
Mean age at surgery was 17.1 years, and median BMI was 50.4, according to the data.
Image Courtesy of Nationwide Children’s Hospital
Results revealed poor functional status among 49% of participants, the researchers reported, with 76% of participants experiencing musculoskeletal pain. Lower back pain was most common (63%), followed by ankle or foot pain (53%), knee pain (49%) and hip pain (31%). Moreover, 26% reported pain at all four sites, they noted.
In adjusted analyses, participants reporting lower extremity pain had greater odds of having poor physical function than those who reported no pain (OR=2.82; 95% CI, 1.35-5.88). Further, those with lower extremity pain had significantly lower Impact of Weight on Quality of Life–Kids total scores (P<.01) and physical comfort scores (P<.01) than those reporting no pain.
The researchers noted no relationship between musculoskeletal pain and high-sensitivity C-reactive protein after adjustment for other factors, according to the data.
“Musculoskeletal and specifically lower extremity pain in severely obese adolescents may be a risk factor and herald a pre-disease state of osteoarthritis, which may be reversible at early stages following bariatric surgery,” study researcher Sharon Bout-Tabaku, MD, MSCE, assistant professor and pediatric rheumatologist at Nationwide Children’s Hospital and The Ohio State University College of Medicine in Columbus, said in a press release.
“For clinicians working with obese adolescents, awareness of lower extremity pain and its impact on functional ability, including adherence to exercise and other physical activity recommendations, is extremely important and needs to be treated appropriately.”