obesity-related structural damage plays an important role in the development or maintenance of pain, the relationship between observable structural damage and pain is a tenuous one. Several researchers have noted that the radiographical findings of joints do not necessarily reflect patients' pain severity reports,113,114 suggesting that factors other than the structural issues may significantly bc involvcd in detcrmin- ing how obesity impacts pain. Similarly, the exact nature of the relationship between inflammatory markers and pain is far from clear, studies have shown conflicting results with the direction and magnitude of the relationship. is Further research is warranted to delineate how these correlates may influence the obesity, pain, and their relationship.