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Bariatric surgery often causes improvement, and often elimination of joint pain in the hip, knee, ankle, and foot.

It also improves quality of life by improving DM, Hypertension, and hyperlipidemia.

However, this weight loss may lead to lower back pain for some. , Especially with laparoscopic gastric banding, and Roux-en-Y gastric bypass, Some patients after Laparoscopic sleeve gastrectomy; had a continuation of their head, neck, shoulder, lumbar spine, and knee pain.

Reasons for that are multifactorial:
1- Ongoing spine pathology as canal stenosis and spondylosis. That will still be there despite weight loss.
2- An increase in abnormal fat distribution, is associated with intraspinal lipomatosis. After surgery, there might be some lag in the rate of lipid dissolution as compared to all body fat.
3- The extreme pressure that obesity puts on the abdomen and other ligaments, tendons, joints, and core muscles can often make them weak, with muscle wasting.
4- In obese patients, a high intra-abdominal pressure unloads the spine, by producing extension of the spine. After surgery, decreasing intra-abdominal pressure results in forward bending and kyphosis, which may result in low back pain and radiculopathy.