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How to Promote Spine Health and Avoid Injury!
Each year millions of children and young adults walk to and from school carrying backpacks that may be causing spine problems. Studies have shown that backpacks can weigh anywhere from 10 or 20 pounds or even 30 pounds or more depending on the age of the student and what is included in the backpack. Often times the backpack will include items such as notebooks, textbooks, laptops, lunches, or even small musical instruments. It is rare that a child or their parents will actually weigh these backpacks. And while formal studies of backpack safety are few, a number of recent studies have shown that individuals that carry more than 10% of their body weight can have spinal disk problems, spine disorders, scoliosis, neck pain, headaches, pinched nerves, and even small fractures of the spine. One small study using a stand up magnetic resonance imaging scanner showed distortion of disk height, abnormal curvature and early signs of scoliosis with caring backpacks ranging from 10% to 22% of the child's body weight. And the Consumer Product Safety Commission has reported that backpack-related injuries are up 33% since 1996.
Warning Signs that the backpack is too heavy:
- The student struggles to put the backpack on.
- When wearing the backpack, the student is forced to lean forward or show incorrect posture.
- Any pain in the neck, mid back, or low back or headaches while wearing the backpack.
- Any tingling or numbness in the arms, legs, or fingers while wearing the backpack.
- Red marks or indentations from the straps.
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Neurology is the field of medicine that deals with the nervous system; this involves the brain and brain stem, the spinal cord, nerve roots, nerve twigs (peripheral nerves), muscles, and how they interact with everything in your body. It is the nervous system receptors that are responsible for appreciating pain throughout your body.
Common neurologic disorders include;
- Stroke (loss of blood and oxygen to the brain)
- Alzheimer’s disease and other forms of dementia
- Parkinson’s disease
- Tremors, movement disorders, and seizures
- Multiple sclerosis, sleep disorders and restless leg syndrome
- Lou Gehrig’s disease (ALS)
- Balance and ambulation disorders
- Tumors of the brain and brain stem
- Spinal cord, neck, and back pain disorders, concussion, and pain syndromes
- Headache disorders, migraines, peripheral neuropathy, and carpal tunnel
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I want to address a very common problem that patients with Diabetes face; Diabetic Neuropathy.
Diabetic Neuropathy is damage that occurs to nerves, usually as a result of high levels of glucose (sugar) over a prolonged period of time. It can affect multiple body parts, and is the most common complication of diabetes.
There are four types of Diabetic Neuropathy, and the symptoms that a patient will experience depends on which type of nerve becomes damaged.
- Diabetic Peripheral Neuropathy: this refers to the small nerve twigs of the body, usually affecting the legs and the feet. Symptoms include pain, numbness, burning, and tingling in the lower extremities.
- Diabetic Proximal Neuropathy: this refers to damage of the nerves of the hips, thighs, or buttocks. This can affect a patient’s ability to rise from a seated position, stand, and even walk.
- Diabetic Autonomic Neuropathy: this affects the nerves of the autonomic (often thought of as the automatic) nervous system. This includes nerves of the gastrointestinal tract (stomach and bowel), urinary tract (kidney and bladder), the genital system (penis or vagina), and vascular system (heart and blood vessels). These problems can include the inability to control the bladder, stomach bloating and constipation, erectile dysfunction in men or vaginal dryness in women, changes in sweating, loss of the ability to regulate blood pressure and pulse (especially on standing after sitting for a while), poor body temperature regulation, and many more.
- Diabetic Focal Neuropathy: this involves anyone nerve anywhere in the body. Depending on where the affected nerve is, this could include problems with vision and focus, pain in the low back, shin, foot, pelvis, chest or abdomen. If the nerve gets compressed, it can lead to painful symptoms. One very common type of problem in diabetics is Carpal Tunnel Syndrome (pinching of the nerve at the wrist).
How Does this occur?
This occurs when the nerves are exposed to high blood sugar levels over a period of time. This seems to impair the ability of the nerves to send messages. It also seems to weaken the walls of the blood vessels which supply nutrients and oxygen to the nerves. But there are other ways that the nerves can be injured; when your body has an immune reaction and the immune system attacks the nerves, thinking they are a foreign material. Genetics may play a role, making some people suffer nerve damage more easily. And smoking, alcohol use and caffeine may also play a role in accelerating nerve damage.
How do I go about getting this checked out?
First of all, you should see your family physician for a general medical check-up if you think you have any of this problems. They will want to know about all of your symptoms, how long they have been occurring if there is any worsening, what your diet and lifestyle are like, and any medicines/ supplements you are taking. If it is determined that you are experiencing nerve problems from diabetes, your physician will refer you to a neurologist, a specialist trained to diagnose and treat conditions of the nerves.
What will a Neurologist do to diagnose your problem?
After a history and physical exam, including an evaluation of your cognition, cranial nerves (nerves that affect the face, eyes, ears, mouth and tongue) muscle testing, coordination, reflexes, sensation (to touch, temperature, position and vibration) and assessment of your feet, most likely diagnostic testing will be ordered.
What are the neurologic tests to diagnose diabetic neurologic problems?
Nerve Conduction Tests (NCV): Usually performed by a certified technician supervised by a neurologist. This test determines how fast the nerves conduct electricity in the arms, hands, legs, and feet. This test can diagnose carpal tunnel syndrome.
Electromyography (EMG): Usually performed with the NCV, this explains how the nerves are supplying the muscles and how the muscles are working.
Autonomic testing: This will apply if there are symptoms of autonomic neuropathy; checking blood pressure and pulse sitting and standing, checking the ability to sweat are just some of the assessments that are done.
OK, assuming I have neuropathy. What’s next? How do I treat it?
There is no cure, BUT, you can slow the progression and minimize the symptoms and alleviate the pain. In general, exercise, weight loss, proper diet, limiting alcohol and tobacco are all essential. But there is more that can be done.
Pain Relief treatments:
Anti-seizure medications: Lyrica (approved for diabetic neuropathy), Neurontin, Tegretol; these medications may provide relief but often have side effects (dizziness, sedation, swelling) as well.
Antidepressants: Cymbalta (approved for diabetic neuropathy), Elavil, Pamelor, Tofranil are often used; side effects can include constipation, dry mouth, weight gain, sweating, dizziness.
Alternative treatments: Topical creams, acupuncture, massage may help.
For more information about diabetic neuropathy and other neurologic conditions, contact the Neurology Office, Joseph Kandel, M.D. and Associates, contact our team of medical professionals to find out what you can do to start on a healthier journey!
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