Going Back to School without Back Pain

  • Millions of children are heading back to school now, and nearly one quarter of these young people have low back pain. How can someone so young already be experiencing pain? Children are at risk for back pain if there is a family history of back pain. Girls are at higher risk than boys. Although family history and gender are not risks that can be modified, there are other risks that can be changed. By reducing the overall risk of developing back pain, a child may be able to go back to school without back pain.  


    General health can be improved.  In particular, tobacco use is a major contributor to premature spine degeneration because of the lack of blood and nutrients to the spinal discs. Smoking causes the discs to age rapidly. Furthermore, sugar consumption causes weight gain and inflammation. Avoiding sugary drinks and foods can tremendously improve the way the spine feels. Transforming poor health into good health is a powerful way to protect a young life from chronic back pain.

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    Backpacks can be lightened. Most children are going back to school with backpacks. In a recent study, children with back pain were found to have excessive loading of the L5-S1 disc while carrying a backpack. The weight of the load and frequency of carrying it were both important factors contributing to back pain in children. The general rule is that a back pack should not exceed 10% of a child’s weight. In addition to lightening the pack, muscle strengthening can also help to improve tolerance of the additional load on the spine. These types of simple changes can greatly reduce the likeliness of back pain because it all adds up.


    Activities can be modified. Many children enjoy playing sports. Occasionally, these extracurricular activities can lead to injuries and pain. Remember, the body is still developing and maturing. Thus, the skeletal structure of a child is not as strong as an adult body. The immature low back is particularly vulnerable with certain sports like gymnastics, football, baseball, and golf. These sports put the spine through extreme postures or repetitive rotation. But instead of discouraging participation, a child needs to follow three simple rules: don’t play through pain, allow for proper recovery after injury or exhausting event, and avoid unnecessary risks. Recently, a young man came to see me after 20 years of competitive baseball pitching. The repetitive twisting involved with pitching lead to back pain along an injury that occurred when he unnecessary took a risk while lifting weights. The lesson here is to play sports but proceed with caution.


    Back pain happens no matter what sometimes. A child can be in perfect health, with a light backpack and no unusually stressful activities, but still develop an achy back. If that occurs, get some professional help from a doctor and physical therapist. There may be other things contributing to the pain that can be changed. The more actively involved we are with prevention and treatment, the more likely children can go to school without back pain.


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    Spine (Phila Pa 1976). 2014 Feb 1;39(3):243-8.

Published On: August 23, 2014