Background: Chronic low back pain continues to be an enigma for clinicians and strain on the US health care system resulting in loss of function and negative psychosocial complications. Long term management requires multidisciplinary care and may include dietary modifications.

Case Presentation: A 35-year-old male (weight: 127.9 kg; body mass index: 36.2 kg/m2) presented with a ten-year history of CLBP and additional comorbidities. He had poor results from prior treatment, which failed to address lifestyle, so an anti-inflammatory diet was added to his care.

Outcome and follow-up: At 8 weeks, his weight and body mass index decreased to 110.2 kg and 31.2 kg/m2, respectively. His functional measures improved, and he reported feeling energized and healthy.

Discussion: Anti-inflammatory strategies in combination with Physical Therapy management of CLBP resulted in considerable weight loss and functional improvement. When patients present with significant body mass and poor diet, addressing these lifestyle factors may be an important tool in the management of CLBP.

Keywords: Inflammation; Nutrition; Obesity; Anti-inflammatory diet; Chronic low back pain