Fat in the back muscles is a cause of chronic pain

At first glance, it seems that the problem lies in the spine or joints. But a new large-scale study says: pay attention to the muscles. Scientists analysed MRI scans of nearly 30,000 people and came to an unexpected conclusion — the more fat inside the back muscles, the higher the likelihood of chronic pain.

The focus is not just on overall body weight, but specifically on the structure of skeletal muscle. The study was conducted as part of the largest NAKO (German National Cohort) project, where data analysis was supported by artificial intelligence. This made it possible to divide muscle tissue into ‘pure’ and fatty tissue and compare the results with the participants’ complaints.

The results surprised even the scientists themselves. Those whose muscles were predominantly fatty complained much more often of constant back pain. On the contrary, the presence of pronounced musculature was associated with a lower risk.

Interestingly, the level of physical activity was no less important. Those who exercised for about 150 minutes a week felt better than everyone else. But extremes — a sedentary lifestyle or excessive training — increased the risk of pain.

“We are not claiming that fat in muscles is the direct cause of pain. But now we know for sure that it is associated with it. This is an important clue,” comments one of the study’s authors, Dr Sebastian Ziegelmaier.

The study does not claim to be the final word on the matter. It only shows a connection, not a cause. But, according to the authors, it could be a starting point for new approaches to the treatment and prevention of chronic pain.

Muscle composition is still rarely checked during routine diagnostics. However, doctors now have a reason to think: maybe it is worth adding another important parameter to the usual examination? After all, we are talking not only about physical discomfort, but also about the lives of millions of people whose quality of life depends on whether their back can simply not hurt.