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backpackAs the new school year is set to begin, thousands of families are back to school shopping! Having the coolest backpack is a back to school must have! However, beware, as carrying heavy backpack loads leads to increases in childhood back pain!

Although a very convenient way to carrying school books and supplies, if not used correctly, it may lead to muscles and joint injuries, and lead to changes in posture, as well as other musculoskeletal dysfunctions. Improper backpack use could close down the thoracic outlet (passageway for blood vessels and nerves as they are transported to the arms from the heart and neck respectively), and interfere with blood flow (to muscles and other tissues) and pinch or stretch nerves, potentially leading to numbness, tingling and weakness of the arms and hands.

Between 2010 and 2011, backpack injuries in kids aged 5-18 increased 6.5% totaling over 13,000 injuries, according to the U.S. Consumer Product Safety Commission. Some of these known injuries include: acute pain, sprains, strains, muscle spasms, stress fractures, inflammation, and nerve injuries.

On a daily basis, parents must pay attention to what goes into their children’s backpacks, as well as the exact type of backpack used by their children. Things that every parent MUST pay attention to includes:

  1. Recommended Backpack features:
    1. Ensure backpack is appropriate for your child’s size, and lightweight when empty.
    2. Backpack should have 2 wide (and well-padded) shoulder straps
    3. Backpack should have an available waist strap
    4. Backpack should have a padded back
    5. Backpack with multiple compartments is preferred as it allows for even content distribution, and prevention of improper weight concentration in any localize portion of the bag.
  1. Recommended Backpack Packing Techniques:
    1. Ensure that your child is NEVER carrying a backpack that is more than 15-20% of their body weight, as this significantly increases risk of injuries.
    2. Pack backpacks with heavier items lower in the bag, and closer to your child’s back.
    3. Use all compartments of the backpack to ensure weight is evenly distributed.
    4. Carry only items required for each day, and leave unnecessary items at school or at home, this minimizes the ultimate weight carried by your child.
  1. Safe Backpack Carrying/Lifting Techniques:
    1. Always keep weight of backpack evenly distributed across your child’s back by using the 2 shoulder straps. They should never carry the bag with only one strap.
    2. Backpack should fit snug against the body, and should rest in the normal curvature of the lower back. It should NEVER be loose or swing around on your child’s back. The straps should be adjusted and tightened to bring the load closer to your child’s back.
    3. Use proper lifting techniques when picking up a backpack. Your child must lift with their knees and not with their back. They should bend at the knees, keeping the back straight when picking up their backpack.
    4. Backpack should not hang lower than your child’s iliac crest (“hip bone”). This ensures the backpack’s weight is kept as close to your child’s center of gravity as possible, which prevents your child from having to bending forward while walking. The lower the your child’s backpack hangs the more forward your child will want to lean while walking which significantly increases the stress on the shoulders and back.
    5. Be sure to discuss using a rolling backpack with your child’s teacher if there are any known back problems or persisting back pain; this prevents additional stresses on back.

Following these tips will help foster good spinal health for your family, and will help avoid neck pain, back pain and shoulder pain, that can come from heavy backpacks or backpack misuse. Don’t wait for your children to complain of back pain prior to taking action. Injury prevention is the key! Improper attention to body mechanics today will predispose your kids to increased risk of future back injuries. As the old English adage goes, “to be fore-warned is to be fore-armed,” do not let your child be one of the 55% of American children annually that carry backpacks heavier than recommended guidelines, which greatly increases the risk of backpack associated injuries.

For additional information or for further guidance, you may call the Spine Specialists at the Spine Institute of Central Florida (863-688-3030) to answer all of your questions. You can also visit us at


Do I have Neuropathy? What could be the Cause of Your Arm and Leg Symptoms?

200177292-001It is very common to receive the diagnosis of “Neuropathy.” What does this really mean? Neuropathy refers to disease or dysfunction of one (mononeuropathy) or more (polyneuropathy) peripheral sensory nerves (nerves that controls sensation) and/or peripheral motor nerves (nerves that control muscle action). Peripheral nerves are nerves not involving the brain or the spinal cord. Symptoms may include: weakness, uncomfortable and painful sensations including burning, tingling, pins and needles, and electric shock feelings in the arms, hands, legs and/or feet.

The most common cause of peripheral neuropathy is Diabetes. However, one can also have peripheral neuropathy secondary to many other diagnoses; including Shingles (posthepatic neuralgia), kidney failure, liver disease, immunodeficiency disorders, lyme disease, autoimmune disorders, hypothyroidism, heavy metal toxicity, and various vitamin deficiencies, to name a few.

Contrary to information you may have received, MOST causes of peripheral neuropathy can be successfully treated or prevented. The key to successful treatment is accurate diagnosis of the specific cause of symptoms, which varies in each patient. The most common mistake is lumping all peripheral neuropathy diagnoses into one basket, and implementing the same treatment plan for every patient. This often leads to failure in reaching the desired treatment goal.

Another common misconception includes patients thinking they have peripheral neuropathy (simply because they have Diabetes), when in fact, the symptoms in the arms and legs are not diabetic peripheral neuropathy at all… but the symptoms are actually being caused by a spine problem.

Spinal problems can lead to leg and/or arm symptoms that may be confused with neuropathy, even by well experienced clinicians. It is important to realize that your spine may be the cause of your upper or lower extremity symptoms if you are having leg pain, or arm pain that is not responding to other treatments.

Additionally, symptoms that may be attributed to restless leg syndrome may be occurring due to spinal causes. Spinal pathologies including herniated discs, bone spurs, spinal stenosis, benign and metastatic spinal tumors (to name a few) may result in leg or arm symptoms including numbness, tingling, pins and needles and weakness. Also, vascular pathologies can also lead to extremity symptoms.

The highly skilled and trained Specialists at the Spine Institute of Central Florida specialize in properly assessing and diagnosing the cause of your extremity symptoms.

After the cause of your symptoms have been accurately identified using specialized diagnostic tests, and examination, an effective treatment plan is developed tailored specifically to the cause of your symptoms.

At the Spine Institute of Central Florida, you can rest assured that we employ a comprehensive multidisciplinary treatment approach in treating your symptoms. Our experts employ cutting edge and highly effective treatments which may include new generation neuropathic oral medications, highly effective topical medications, specialized infra-red based therapy programs, neurodiagnostic injections, diagnostic epidural injections, transforaminal injections, peripheral nerve blocks and steroid injections, spinal cord stimulation, neuromodulation therapies, peripheral nerve field stimulation (PNFS), and state-of-the-art cutting edge minimally invasive spine surgical procedures aimed at relieving your symptoms, restoring function, and getting you back to doing what you love. We empower our patients to be involved in all decision making relating to their care.

The important take home point is: if you have extremity (arms, hands, legs, and feet) symptoms that are persisting, or not responding to current treatments, you should seek a second opinion. It may not be neuropathy, or it may be that the exact cause of your neuropathy is not yet identified. Remember, ALWAYS take full control of your health, get informed, and don’t leave the decision of what will give you the best quality of life to someone else. Ask questions of your physicians, seek other opinions, and then make an informed decision of which treatment(s) will best suit your needs.