It’s that time of the year! Students are officially returning back to the classroom and hitting the books as the new school year kicks off. Along with a student’s busy schedule, a backpack filled with books, binders, lunches, laptops, iPods and gym clothes can easily pack on the pounds and lead to improper fit, causing back strain and pain to a child’s back.

According to the U.S. Consumer Product Safety Commission, in 2010, nearly 28,000 people were treated in hospitals, doctors’ offices and emergency rooms for backpack-related injuries including strains, sprains, dislocations and fractures.

To avoid pain and discomfort caused from heavy backpacks, the American Academy of Orthopaedic Surgeons recommends the following safety tips:

·         Always use both shoulder straps to keep the weight of the backpack better distributed.

·         Tighten the straps and use waist strap if the bag has one.

·         Remove or organize items if too heavy and place biggest items closest to the back.

·         Lift properly and bend at the knees to pick up a backpack.

·         Carry only those items that are required for the day.

·         Encourage you child or teenager to tell you about pain or discomfort that may be caused by a heavy backpack, like numbness or tingling in the arms or legs.

·         Purchase a backpack appropriate for the size of your child and look for any changes in your child’s posture when they wear the backpack.

·         Watch your child put on or take off the backpack to see if your child or teenager expresses discomfort.

                                         ·         Talk to the school about lightening the load. Keep the load at 10-15 percent or less
                              of the child’s bodyweight.

                                         ·         Be sure the school allows students to stop at their lockers throughout the day.

For more information about backpack safety, please visit AAOS at: http://www6.aaos.org/news/pemr/releases/release.cfm?releasenum=1014

Photo and Image Credits:

Freedigitalphotos.net- Photostock

Written By D. Troy Trimble, D.O.

Many injured workers have pre-existing degenerative conditions. Many times, these degenerative conditions have not produced symptoms up until an injury. This injury could occur at work or at home, but in many cases, was not producing symptoms until some precipitating event. At this point, the question becomes – “Who is responsible?” 

In the world of spine conditions, we know that almost 50 percent of individuals in their 50’s have degenerative findings on lumbar MRI. This occurs even in a subset of study individuals who have never had complaints of back pain. What this shows is that degenerative conditions do not necessarily produce symptoms.

The main issues in the injured worker then become the all-important, major contributing cause or major contributing factor. In my practice, if a patient has never presented for a neck or back injury to any type of spine care practitioner prior to a work injury, then I consider the work injury the major precipitating event. However, if this individual has been treated for prior back or neck problems, then the work injury is considered an exacerbation of a pre-existing condition (if the pain goes back to baseline) or an aggravation of a pre-existing condition (if the pain stays at an elevated level).

Written By Phillip Parr, M.D.

Low back pain prevails in our society. Eighty percent of us have severe back pain in our lifetime. The vast majority of these injuries resolve within six weeks, even without treatment. Low back injuries in the workplace are the most common industrial injuries causing lost time from work.

The primary cause of most back injuries is poor body mechanics when lifting, twisting and doing repetitive motions. Many injuries result from falls from scaffolds, ladders and other unpredictable accidents. In addition, many workers doing heavy labor are predisposed to injury because they are overweight, unfit and have unconditioned core structures.

In some people, low back pain comes on gradually over a period of time, frequently after doing repetitive motions and lifting. Commonly, these symptoms do not start until one or two days after the activity.

Other workers have a sudden onset of pain, which they describe as a "catching or popping sensation" followed by severe spasms or inability to move or bend. Acute pain that goes into the buttocks or down the leg suggests an injury to the intervertebral disc. Acute catching sensations indicate mechanical low back pain. This is often associated with biomechanical abnormalities of the spine itself, such as spondylolysis or spondylolisthesis, defects in the lower lumbar spine as a result of hereditary problems.

Principles of Treatment

Acute injuries to the low back should be referred to a physician quickly for aggressive diagnosis and treatment. Sending a worker home to rest for a few days to see if his or her symptoms clear almost always fails and frequently results in delayed and prolonged treatment. Initial evaluation should always include X-rays to rule out fractures, other degenerative changes or deformities of the spine. Patients with neurological symptoms, or radicular symptoms into the lower legs should get an MRI scan to rule out a herniated disc. Acute symptoms should be treated with relative rest. Total bed rest is seldom indicated and is usually detrimental. The patient should be encouraged to get up and move around as much as possible.

Medications for acute symptoms include muscle relaxants, non-steroidal anti-inflammatory and pain medicine. Narcotics should be used prudently and for short periods of time. A semi-soft back support frequently is helpful in reducing the initial symptoms, as are modalities; ice, ultrasound and E-stim. The most important part of any treatment program for low back injuries should include early, aggressive and active physical therapy. Passive modalities, such as manipulation and massage may give temporary relief, but are of no long-term value. The emphasis should be on regaining flexibility and strengthening the core structures to support the spine. This includes the abdominal and oblique muscles and the paraspinous muscles in the lumbar area.

The other key element in any rehab program should be returning the worker to the workplace as soon as possible on some form of light duty. This keeps them in the work mode and prevents the depression and chronic pain syndrome that frequently occur with long-term lay-offs. Research has shown that workers who stay out of the workplace more than six weeks are much more difficult to return to their previous occupation.

Indications for Surgery

Fortunately, most workplace accidents do not require surgical treatment.

Unstable fractures of the spine need quick surgical stabilization, so that they can be mobilized.

Compression fractures can cause long-term disability and pain. Vertebroplasty greatly reduces long-term disability associated with this injury.

Large herniated or extruded discs compressing a nerve root, resulting in severe neurological deficit, or pain, can generally be treated with a simple diskectomy. Now, with today's modern instruments, this can generally be done as an outpatient surgical procedure using a small incision.

Early diagnosis and evaluation of acute back pain, limited use of narcotic medications and emphasis on active core strengthening exercises are the keys to returning workers to the workplace in a timely fashion.