Being overweight can literally be painful. A recent study found that being overweight or obese increases the risk of pain in people with musculoskeletal disorders. Read: Mexico-US border restrictions do not block COVID-19

“Pain, osteoarthritis, and weight share a complex relationship,” said study author Dr. Diana Higgins, a researcher with the VA Health Care System and the Boston University School of Medicine.

“Overall, the heavier a patient with a musculoskeletal disorder is, the more likely they are to report experiencing pain, which could affect functioning and quality of life,” Higgins said in a VA news release.

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The researchers analyzed data from nearly 2 million US veterans. USA with musculoskeletal disorders, for example a non-traumatic joint disorder, arthritis, or low back, neck or back pain.

Overall, 58 percent said they were in pain. Almost eight out of 10 patients were overweight or obese. The higher a patient’s body mass index (BMI) was, the more likely he was to report pain. BMI is an estimate of body fat based on height and weight.

Compared to those of normal weight, those of moderate obesity (a BMI of 35 to 39) were 9 percent more likely to report pain. And those with morbid obesity (a BMI of over 40) were 23 percent more likely.

The connection between excess weight and increased risk of pain was more powerful in arthritis patients: 40 percent of overweight patients and 55 percent of morbidly obese patients reported pain.

The association between weight and pain was less pronounced in patients with back or lower back pain, according to the study. The findings were published in a recent issue of the journal Pain Medicine.

Although the study shows a link between weight and pain in arthritis patients, more research is needed to understand this relationship, the authors said.

Joint stress from excess weight could lead to arthritis pain, but that relationship could also go in the opposite direction, they suggested. Arthritis pain could cause patients to avoid physical activity, which could result in a higher BMI.