We are all painfully aware of the lower back pain epidemic. To borrow a rather timely, if slightly morbid, phrase from Shemot 12:30—”Ki ein bayit asher ein sham meit”—not a single home has not experienced the dread of lower back pain. In fact, it is estimated that up to 80 percent of Americans will experience lower back pain at some point in their lives. It is the leading cause of disability worldwide and the second-most-common reason for visits to the doctor’s office.
While the prevalence of lower back pain in adults is unfortunately all too familiar, one growing segment of the population that often goes unrecognized is adolescents. Over the past several years a number of studies have focused on back pain in children with the goal of determining how prevalent it is, why it’s happening, and what might be done to address this growing problem. These studies performed in the U.S., Europe and South America revealed a number of unexpected findings. First, up to 48 percent of adolescents reported at least one significant episode of back pain. Second, incidence of lower back pain increases with age and is a strong predictor of adult lower back pain. Third, females are affected more than males. But the most common finding was the strong correlation between lower back pain and inappropriate home posture habits.
With the ever-increasing popularity of smartphones, tablets, gaming systems and other devices, more and more people are spending large portions of their day staring at screens. In fact, a July 2016 survey by The Nielsen Company found that the average American spends well over 10 hours a day consuming media from our personal devices, computers and TVs. As a result we are finding ourselves maintaining fixed positions for longer periods of time each day. Amazingly, adolescents spend more! A recent survey by CNN found the average American teen to be spending over nine hours a day alone using media for their own enjoyment, not to mention the many hours daily used for school work.
Gone are the days when a child would come home from school, throw his or her backpack down and run outside to play until dinnertime. Instead, consider the following scenario, which is based on a discussion I recently had with a 14-year-old patient whom we’ll call Josh, as we reviewed a typical school day. Josh wakes up with the alarm from his smartphone, quickly checks all the texts, Snapchats, Instagram messages, Facebook posts and sports scores that he missed from the night before. Then he’s off to school where he spends much of his time sitting at a desk working out of a laptop or tablet and staring at a Smartboard (not to mention checking his phone during every possible break). Then at home he’s back to a combination of video games to unwind, laptop for homework and his phone, which he checks several dozen times per hour.
Much of the time when a person uses a device with a screen, he or she is slouched forward or contorted in an unnatural way. When an individual sits in a slouched position he or she is placing a great deal of strain on the posterior structures of the spine including the musculature, ligaments, joints and even the intervertebral discs. If this posture is maintained for long periods of time and repeated consistently these structures are subject to strain and potential injury.
Fortunately, symptoms associated with lower back pain can be successfully treated with physical therapy that addresses pain and soft-tissue restriction and works toward improving strength in important core musculature. But, the most important focus of treatment would be to assess posture and body mechanics in order to educate teens about safe and appropriate positions in which to work and use their devices so they can remain productive and healthy.
By Ephraim Yablok
Ephraim Yablok, MS, PT, DPT is the owner of Roots Physical Therapy, LLC, which specializes in pediatric and adolescent orthopedic physical therapy and rehabilitation. He can be reached at 201-455-6885 or [email protected].
