Importance of body measurements in development and treatment of chronic pain

Introduction: Body mass index (BMI) has been shown to negatively correlate with outcomes in Spinal Cord Stimulation (SCS). However, hip and waist circumference (HC and WC respectively) have become recognized as more accurate measurements of body fat. In order to determine how these measurements affect outcomes with SCS, it is first necessary to define normal ranges in patients with chronic pain. Further to ensure that all genders, races and ethnicities receive therapy for chronic pain, it is necessary to obtain a representative sample from across U.S. We used the NIH-sponsored All of Us database to determine the relationship of waist and hip circumference and chronic pain across groups.

Methods: We investigated waist circumference (WC), hip circumferences (HC) and the waist/hip ratio (WHR) across different cohorts categorized by sex, race, ethnicity and presence of chronic pain. All participants were further divided into four cohorts (total, without chronic pain, those with mild/moderate chronic pain (numeric rating scale (NRS) < 7), and those with severe chronic pain NRS > 7.

Results: A total of 204,013 participants aged between 18 and 100 years were included. 25.22% of the total cohort had chronic pain diagnoses with 80% described as either chronic pain not otherwise specified or fibromyalgia. In all cohorts, females had significantly greater HC while males had greater WC and WHR. Race and ethnicity also had a significant effect on HC and WHR. WC, HC, and WHR were significantly greater in the severe pain group as compared to the mild moderate pain group ( < 0.001).

Conclusion : When offering treatment to patients with chronic pain, it is important to holistically manage patients. These data suggest that when assessing hip and waist circumference demographic variables need to be considered. Patients with severe pain have higher values in all groups and this should be considered when assessing outcomes with SCS or any pain therapy.