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Every time I see the doctor for my back pain, I hear the same thing: "lose weight". I had back pain before I gained weight. In fact, I gained weight because I can't exercise with so much pain. What can I do?

There's no doubt that weight loss is difficult for many people. Right now, one-quarter of the U.S. and Canadian populations are considered obese by medical standards. Children are quickly outpacing adults in this area. Type two diabetes associated with obesity is on the rise in all age groups -- children, teens, and adults. Studies show that obesity is linked with low back pain. The exact mechanism by which this develops remains unclear. Likewise, studies that show reduced low back pain with weight loss doesn't explain the relationsip between diet, exercise, weight loss, and reduction in low back pain. It's possible that the effects of weight loss on physical activity (increased daily activity at home and at work) someone turns off inflammatory cycles that contribute to joint and low back pain. Fat is a highly active substance in the body. It can produce chemicals that promote inflammation. Less fat could mean fewer inflammatory cells and thus less pain. Exercise is a key element in weight loss and reducing low back pain and disability. The condition of obesity causing musculoskeletal pain and pain preventing exercise leads to a viscious cycle of no exercise. Yet many people find their pain is no worse when they exercise than when they don't. So, with their physician's approval, they exercise anyway. Pool exercise has become a very popular way to burn calories without stressing the spine or joints. Most health clubs offer water classes for those who are not already fit or who have joint problems requiring a modified approach. A stationary bicycle is also fairly easy to ride at your own pace. Hand weights can be used in the sitting position and offer another way to build muscle, use up calories, and strengthen body parts all at the same time. Talk with your doctor about what might work best for you. If it will help you get started, use pain relievers with your physician's guidance. If one approach doesn't suit, don't give up. Keep trying to find the one type of exercise or combination of activities that works for you. Do what you can even if it is in one-minute increments. Start slowly and build up your tolerance. Good luck!

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