• The prevalence of obesity has been steadily increasing since the 1960s. Currently about one third of the adult U.S. population is obese. The implications for the working population are yet to be fully realised. The lost productivity yearly due to obesity is estimated at $12 billion.   Obesity is associated with a high incidence of work-related musculoskeletal disorders. It has been suggested that obesity is associated with more spinal pain, mainly low back pain (LBP)  and neck pain  The cost of spinal pain for the US workforce is estimated at $20 billion annually.  Together, obesity and spinal pain represent two clinically and economically important public health problems that drive health care use.

    Obese individuals, compared to lean individuals, are more likely to experience neck pain and LBP, are expected to have a slower recovery, and are more likely to seek healthcare for LBP.  This suggests that not only might it cost more to treat obese patients but also that obesity might be a prognostic factor for long-term functional limitations and increased health care expenditure

    We are afraid to say that being overweight and having back pain(LBP) is not a good omen for a speedy recovery. Overweight and obesity are associated with higher levels of disability before physical treatment in LBP patients. The more obese you are the least likely you are to respond to  physical therapy treatment and we should be in particular, be  investigating  treatment strategies combining weight management, cardiovascular fitness, and low back pain rehabilitation.