In the neck and back, we have discs that separate our vertebra, or spinal bones.   These discs provide for optimal motion, structure, and shock absorption.  The disc has two layers.  The outer layer is called the annulus fibrosis, and the inner layer is called the nucleus.  The annulus is made up of cartilage, while the nucleus is made of a gelatinous material. 

School is officially back in session.  Every September, the issue of heavy backpacks and back pain in kids and teens is brought up.  Here are some general tips with regard to backpack safety and avoiding injury:

1.  Pick the right backpack, making sure the shoulder straps are padded.  It should be the right size for the child.  The bottom of the bag should not sag too far below the belt line.

2.  If possible, avoid loading it too heavily.  15 to 20% of the child's body weight should be the most that the backpack weighs.  In some situations when a school aged child has been having back or neck pain, I've been able to write a note requesting another set of books, so that a set could be kept at home and not need to be carried to and from school.  If a heavy backpack is unavoidable, you may consider a backpack that has wheels and an extendible handle.

3.  Practice proper lifting techniques when lifting the backpack from the floor.  Check my previous blog on this subject.

4.  Make sure the backpack is fastened high and tight, so that it doesn't sag.  Use both shoulder straps, not carrying the bag on just one shoulder.

5.  Load the backpack with the heaviest items closest the the childs body.  Use the various compartments to do this.  This will help more evenly distribute the weight.

Thoracic outlet syndrome is a painful condition that is associated with neck pain, arm pain, numbness and weakness to the arms and hands.  There can be several causes.  In my practice, the most common cause is spasm and irritation of a group of muscles called the scalenes, which are located behind and under the clavicle (collar bone).  Usually there is underlying dysfunction of the neck and upper back.  In response to this, the scalene muscles go into spasm.  There is also a degree of inflammation, which causes the surrounding tissue to swell.  This will put pressure on a bundle of nerves called the brachial plexus.  The brachial plexus has branches of nerves that control muscle and skin sensation to the arm and hand.  The result of pressure on the brachial plexus is pain, weakness, and numbness to the arm and hand.  Other causes of thoracic outlet syndrome include direct trauma and the presence of a cervical rib.

Treatment for thoracic outlet in my practice typically consists of chiropractic adjustments to the neck and upper back, as well as at the effected shoulder girdle.  Heat and electric muscle stimulation is often used as an adjunct to help relieve muscle spasm.  Home stretching and postural exercises are also added when the patient is ready. 

As of today, I have earned an advanced certification in Whiplash Biomechanics & Injury Traumatology.  The certification comes from the Spine Research Institute of San Diego.  Dr. Arthur Croft was the instructor for this program.  Dr. Croft is an author and an expert on the subject of whiplash.  I consider him to be one of my most influential mentors.

Since much of my practice is dedicated to treating patients with whiplash injuries, I especially value the information I've learned in this program.  Staying on the cutting edge of research and information is another way that we strive to better serve our patients.