It’s back to school time again, and each year many children get a new backpack to carry supplies, books, and homework. These carry-all backpacks often reflect the personality of the child, with many adorned with super heroes, princesses and more than a few Angry Birds.

back-to-school2While this efficient carrying case has been around for many years and has been used by millions of students both old and young, back experts such as Texas Back Institute physician Dr. Rey Bosita have noticed a problem with backpacks. They’re too heavy for some kids, and can cause long-term serious back problems.

We spent a few minutes with Dr. Bosita to get some guidelines on the proper size and use of backpacks. More on this later.

Backpacks Have a Colorful History

Backpacks, in one form or another, have been around since early humans used animal skins to carry meat from hunting trips. Just as with the school kids of today, these packs allowed prehistoric hunters to use the strong muscles in their backs to carry much more game for longer distances than if they were carrying it in their arms alone.

Historians note that the term “backpack” was coined by Americans around 1910; however, before it was known as a backpack, Europeans (specifically the Germans) called this carry-all a “rucksack,” which is a shortened version of the phrase “der Rucken” – German for “the human back.”

Up until the 1950’s, the backpack was primarily used for hunting and military purposes. These early versions were made of rugged materials and very heavy to carry. All of this changed when hiker Dick Kelty realized backpacks could serve a valuable function to the participants of his sport. He began experimenting with creating packs made of lighter materials and more compact designs. He also changed the weight distribution of the backpacks – by putting the skids of the pack in the back pockets of his hiking pants – allowing the hips to carry more of the load.

With this change, anyone who needed to carry several items while they were walking could pack these in a backpack and be on their way. It didn’t take long for parents and students to discover  these same, light-weight backpacks were ideal carrying cases for schoolbooks and homework papers.

The Problem with Backpacks

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For all of its efficiency, the modern backpack has its detractors, some of whom are backspecialists. In an article published in 2012 in the New York Times, it was noted that “heavy backpacks don’t just zap children of energy that might be better used doing schoolwork or playing sports. Lugging them can also lead to chronic back pain, accidents and possibly lifelong orthopedic damage.”

In this article on the dangers of backpacks for kids, the federal Consumer Product Safety Commission calculated that “carrying a 12-pound backpack to and from school and lifting it 10 times a day for an entire school year puts a cumulative load on youngsters’ bodies of 21,600 pounds – the equivalent of six mid-sized cars.”

In a 2012 report in the “Archives of Disease in Childhood,” researchers in Spain assessed the backpacks and back health of 1,403 pupils, ages 12 to 17. More than 60 percent were carrying packs weighing more than 10 percent of their body weight, and nearly one in five had schoolbags that weighed more than 15 percent of their own weight.

This study found that “1 in 4 students said they had suffered back pain for more than 15 days during the previous year; scoliosis – curvature of the spine – accounted for 70 percent of those with pain. The remaining 30 percent had either low back pain or contractures – continuous, involuntary muscle contractions.” Girls faced a greater risk of back pain than boys, and their risk increased with age.

Clearly, there is a potential problem with backpacks and kids. In many cases, they are either too heavy for the size of the child or they are being worn by the child incorrectly. We spoke with Dr. Rey Bosita, a spine specialist with Texas Back Institute, to get an idea on the “dos and don’ts” for backpacks with kids.

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Dr. Bosita noted pain often results when the weight of the pack pulls children backward, prompting them to bend forward or to arch their backs to keep the pack centered. These positions make the back muscles work harder and increase pressure on vertebrae on the discs between them.

If the child has to lean forward or seems unsteady when walking with a loaded pack, it’s too heavy.  This can lead to poor posture and shoulder pain.  Neck pain can also occur when the child is forced to look up from this position.

No parent or teacher wants a child to be injured by a backpack which is too heavy. So, what should be done to correct this situation? Dr. Bosita has some ideas.

Tips You Can Use for Back Safety and Backpacks

“The first thing we should look at is how the backpack fits the child and how he/she is standing while wearing it fully-loaded. The child should be standing straight up – with shoulders back. The backpack should be positioned in a manner that allows it to rest against the child’s back, straps a little tighter, so that the pack doesn’t sag too low,” Dr. Bosita notes.

Another important consideration for back safety is the weight of the backpack. What is the correct weight for a child’s backpack and how does a parent determine the weight of the pack? Dr. Bosita says, “The easiest way to determine the acceptable weight of the pack is to get the family scales out and weigh the child without his/her backpack. The weight of the backpack should be no more than 10 to 15 percent of the child’s weight. Therefore, if the child weighs 50 pounds, the backpack should not weigh more than 5 to 7 pounds.”

“Remember, everything adds weight to the backpack, including the pack itself, Dr. Bosita notes. “It’s a good idea to check the backpack weight with all of the materials connected to the pack (water bottles, knick knacks) and the books and school supplies being carried in the backpack (library books, binders).”

For the complete video of Dr. Bosita’s tips on backpacks, just click here 

Pack Only What’s Needed

When given the chance, younger children will stuff as many things as possible in their backpacks, much of which is not related to school work. Parents should take a minute each morning and afternoon to inventory the items being transported to and from school. If there are toys, games, handheld computer games, pet rocks, frogs and other non-academic items being packed in the bag, remind the child that these things should be left at home.

If he or she disagrees about the contents of the backpack, have a Plan B. Just tell them that you want them to grow up straight and tall and a heavy backpack might keep this from happening. This has the advantage of being the truth.

And if this fails, reward them with a treat  if they keep the back pack light.

Failed Back Surgery Syndrome

The post below was featured on Spine-Health.com and was contributed by Dr. Stephen Hochschuler, co-founder and orthopedic spine surgeon at Texas Back Institute.

Failed Back Surgery Syndrome (FBSS) refers to chronic back or neck pain, with or without extremity pain, which occurs if spine surgery does not achieve the desired result. Contributing factors include recurrent disc herniation, compressed nerves, altered joint mobility, scar tissue, muscle deconditioning and degeneration of facet or sacroiliac joints.

The problem of failed spine surgery has long been a perplexing and intriguing problem my colleagues and I have tried to accurately analyze and pro-actively prevent. My goal as a spine surgeon is to help treat patients with pain stemming from their spine. Many times I am able to treat patients with nonsurgical treatment options, such as physical therapy or medication, and they do very well. In some instances though, this treatment plan does not provide patients with the pain relief needed so we have to pursue more aggressive treatment options including surgery.

I always consider surgery to be a last option approach to spine care and therefore am very careful to make sure my patients are in the best position to have a successful surgery, in turn minimizing the chances of FBSS. Through experience I know there are several factors that have shown to contribute to failed back surgery syndrome, and therefore I follow the protocol below to make sure my patients are set up for their best outcomes:

  1. Before the surgery:
    • Always treat patients conservatively (non-operatively) first
    • Make sure the patient is correctly diagnosed – meaning that the cause of the patient’s pain has been accurately identified
    • Provide a thorough pre-operative evaluation
    • Make sure the surgery is the right one for the patient
    • Appropriately educate and set expectations for the patient, including pre-operative psychological evaluations.
  2. During the surgery:
    • Take all proper precautions to minimize intra-operative issues.
  3. After the surgery:
    • Keep a close eye on post-operative recovery
    • Work closely with the patients’ interdisciplinary care team.

If you are considering spine surgery, it is important to sit down with your surgeon and determine how he actively attempts to minimize the risk for failed back surgery syndrome. If you have been diagnosed with FBSS, it is not necessarily the end of the road. There exist many alternative treatment approaches to deal with this syndrome, but once again one size does not fit all. It is important to find a surgeon who has experience in treating patients with FBSS and can offer you multiple treatment options.

Is chronic back pain making you depressed?  Dr. Andrew Block explains.

Chronic pain is a problem affecting nearly 1/3 of the population in the US and depression is one of the problems which can accompany chronic pain. Statistics show about 85% of patients who have chronic pain experience symptoms of depression.

Some symptoms of depression include:

  • Sleep disturbance – which includes sleeping too much or too little
  • Appetite disturbance  – eating too much or not eating enough
  • Loss of interest in previously enjoyable activities
  • Withdrawal from other people
  • Shortened sense of future or a fear of dying
  • Loss of motivation

These symptoms plus a whole host of other symptoms make it very difficult to recover from chronic back pain.  In fact, there are a lot of indications chronic back pain and depression have primarily the same symptoms and they feed off of each other.  For example, when someone is hurting – they don’t sleep well, they lose their motivation and their enjoyment in life, which in turn creates depression and enforces chronic pain.

Fortunately there are many types of treatment available for chronic pain with depression.

Some treatment options of chronic pain with depression include:

  • Anti-depressant Therapy –  Anti-depressants help to relieve the symptoms of depression but because the same biochemical pathways are involved in depression and chronic pain the anti-depressant medication can also have a secondary effect providing some pain relief.
  • Cognitive Therapy – This type of therapy involves helping the patient observe their surroundings and find things they enjoy in their situation even though they are in pain. This helps the patient to be optimistic and the focus is not so much on the pain but the gains and good things in their lives which remain.
  • The above treatments can also be combined with physical therapy exercises and rehabilitation to further help the patient learn ways to manage their pain.

If you are experiencing depression related to chronic back pain, don’t despair.  There are many treatment options available to help you.  Call us today and we can help get you the treatment you need.

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