What is causing back and neck pain in our Children?

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14 July, 2018

Dr. Jeanne van Straten

M.Tech Chiropractic (UJ)

There is a growing concern between parents about the weight of school backpacks and the effect thereof on their children. This is also evident in private practice as more children complain and receive treatment for back and neck pain as well as headaches.

heavy backpacks may lead to children experiencing back painWhen a child carries a heavy backpack, extra load is placed on the back. In 2010, Dr. Timothy Neuschwander of University of California assessed the spines of eleven year old children in an upright MRI scanner, first with empty backpacks, then with backpack 4,5kg, 9kg and then 13,5kg backpacks (indicating 10%, 20% and 30% of their bodyweight respectively).

MRI results showed decreased disc space, especially in the lower back. Children also had to adjust their postures to adapt to the increased weight by leaning forward, affecting the biomechanics of the spine.

This increases hip flexion, causing further load on the back muscles which will lead to lower back pain. The head will automatically lean forward, placing added strain on the posterior neck and shoulder muscles (anterior head carriage). This posture leads to neck pain as well as headaches.

When the body is placed in a forward tilted position for prolonged periods of time, postural imbalances will occur affecting neural health and  muscle strength and ultimately lead to spine related problems when children grow up to become adults.

Poor posture does not only affect the musculoskeletal system but also the mental health of an individual. Professor of Health Education Erik Peper at the University of San Francisco advised that poor posture can lead to feelings of depression or decreased energy and low levels of confidence.

Taking into account that heavy backpacks can affect our children’s posture, lead to musculoskeletal and discogenic disorders and even affect our children’s mental health as adults, isn’t it time to address the problem at hand?

According to Dr. Dee, a few factors should be taken into account when assessing a child who suffers from back and neck pain.

  • Is the back pain hereditary? Does someone in the family also suffer from similar symptoms?
  • Is there low muscle tone involved? Does the child have rounded shoulders or poor posture? Do they lie on a table when doing homework or struggle to write due to poor shoulder strength?
  • Is ergonomics sufficient for their body type? Is the chair or table the correct height?
  • What do their school bags look like? Does the child carry their school bag on both shoulders? Does the child have a trolley bag or carry bag? What is the weight of the bag they carry?

Parents of children who suffer from hereditary back pain and low muscle tone are usually aware of their child’s problem before school going age. It would have been picked up by either a preschool teacher, family member or physician and treated accordingly.

Ergonomics in terms of table and chair height have not changed in the last few centuries, but children’s bodies have not either which rules out the factor of ergonomics and leaves us with the child’s schoolbag.

Parents and teachers should ensure that children carry backpacks correctly over both shoulders and close to the body to prevent excessive force on the child’s back. Parents should also teach children to not carry extra weight such as unnecessary textbooks, laptops or tables.

International guidelines advise that a child should carry between 10% and 15% of their body weight. This is however not the case as the backpack-body weight ratio is closer to 20%-30%.

Many parents advocate trolley bags to lessen the load on their child’s back although some healthcare professionals advise that spinal rotation can also occur due to slight rotation of the back while pulling a trolley.

Schools will argue that children should still carry trolley bags up and down stairs to not damage stairs. That being said, if a trolley is too heavy it will also have implications on a child’s back and spine which will leave parents with the same dilemma.

When taking all factors in terms of school bags or trolleys into account, the weight of the schoolbag is the main problem. A general consensus should be reached where both parents and teachers advocate less weight for schoolbags or trolley bags being carried or pulled by children where 10%-15% body weight of the school bag should be applied.

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