Back pain affects 80% of adults. It is also common in adolescents and children. One in seven adolescents will visit a doctor for back pain. Work causes most injuries in adults but sports cause most back problems in children. Obesity, smoking, poor fitness, scoliosis and improperly worn backpacks all will cause pain. Regular exercise and good dietary choices improve back pain and your general and spinal health. Your neurosurgeon can help you recover without surgery.
Diagnosing Back Injuries
The evaluation of back pain includes a full history and physical exam. Leg pain, weakness or numbness, bowel or bladder problems, fever, or pain lasting more than two weeks all may indicate the presence of a serious problem. In kids, pain interfering with play or gym class, pain that causes a change in posture, and any pain in a child of less than four is worrisome. If the history and examination are worrisome, laboratory tests and x-rays may be needed. These can include blood counts and plain x-rays of the back. CT scans and MRI scans are usually done only if surgery is considered.
Scoliosis is an abnormal curvature of the spine. Gentle front to back curves are normal, but if the bones are rotated or curved to one side, there will be visible deformities, pain and, in severe cases, lung and heart problems. Braces, exercise and even injections can relieve symptom. About 50% of people with scoliosis will need surgery.
Millions of children walk to school with heavy backpacks. A heavy backpack can increase the risk of falls, cause muscle strain, and overload the low back. Carrying backpacks over one shoulder is especially bad. It is not clear that backpacks cause permanent damage, but it would be sensible to limit a backpack's weight to no more than 10 or 15% of the childŐs weight. If using a backpack causes pain, don't let your kids use a backpack. A second set of books left at school can eliminate the need for a heavy pack.
Obesity is America's worst public health problem. Overweight people have more hypertension, high cholesterol, diabetes, heart attacks, arthritis, sleep apnea, cancers, and especially low back pain. The body mass index, or BMI, is used to determine if someone is overweight. The table below is for a 5'9" person. Subtract 5 pounds per inch if you are below 5'9" and add 5 per inch if you are taller.
Obesity, already epidemic in adults, is rapidly becoming common in kids. Video games, a lack of outdoor activities, and fast food have all been blamed. The body mass index in kids can be calculated with the same equation, but the normal value varies with age.
Recent scientific studies showed that smokers had a much higher risk of back injury. The nicotine slows healing.
Coughing is a common cause of disc rupture. There are medications that can help you quit smoking. Anyone who wants to quit smoking may come to see me. If you are serious, I will help you and will not charge for smoking cessation treatment.
NASA studies showed that waking an extra two miles a day will increase metabolism, strengthen the bones, promote weight loss, and improve heart health. All exercise is good for the back. Studies show that if you do not exercise, you will have more back pain. Walking a mile is better for you than running the same distance. Walking causes less impact on the spine, knees and hips.
If Everything Else Fails
If exercise, weight loss, and other self care does not relieve pain, your doctor can try medications, massage, physical therapy, or chiropractic. Pain injections are often helpful but surgery should be your last resort.
If you have spine problems see a neurosurgeon
Neurosurgeons specialize in spinal problems and carpal tunnel injuries.
For a body mass calculator see . For information on pediatric health see PediatricEducation.org. For information on childhood obesity and fitness see cdc.gov/nccdphp/dnpa/npa-proj.htm