Back on Track

Health Education For Schools

Back pain affecting 72% of primary school children – it’s not just about heavy bags

Two paediatric physiotherapists (Helena Webb from NHS ABMUHB, Swansea and Lorna Taylor from Jolly Back, Derby) have demonstrated excellent collaborative working by gaining evidence into the extent of back and neck pain affecting today’s primary and secondary aged children, it’s risk factors and ideas schools, parents and children can follow to help reduce it.

The pair have also developed a new back health education programme “Back on Track” which is currently being piloted with the hope that it can be rolled out to schools Nationwide as part of the PSHE curriculum.

Back pain is the leading cause of sickness absence from work. Every day it costs the NHS £1.3m everyday it costs the UK £13m in sickness benefits. Every day, it costs the UK economy £37m, that’s £19 billion every year (BackCare.org.uk). Studies show that children who suffer back pain are 4 times more likely to experience it as an adult. Prevention and the  formation of good, healthy habits early on its essential. We need to make sure that children’s back are fit for the future.

Locally, Helena Webb noticed an increase in the number of children and adolescents referred to NHS paediatric physiotherapy for back and neck pain (up from 2.1% in September 2011 to 4.5% in March 2012). “While talking with patients during treatment sessions, I gained an insight into the situations pupils thought contributed to their pain – sitting on the floor, in assemblies, uncomfortable school furniture and carrying heavy bags in the absence of lockers”.

“The NHS is moving forward with health promotion and injury prevention strategies which have be proven to be financially more effective” Ms Webb added.

After an internet search “back pain in children”, Ms Webb contacted Lorna Taylor at Jolly Back – also a paediatric physiotherapist. “It was great to be contacted by someone as passionate and proactive as Helena. I have spent several years focussing on raising awareness about the importance of spinal health and ergonomics in schools for children and their teachers. I have developed the Derby City Healthy Schools Adolescent Back Pain Prevention Enhancement which was a great starting point for this initiative. Changing lifestyles are having a detrimental effect on young growing spines but the good news is, there are many things which we can all do to help”.

Ms Taylor and Ms Webb discussed how they could raise awareness of the growing problem of back pain affecting children, the need for young people to think about back health whilst still young and to change the mind-set that it is not “just for adults”.

“Schools naturally seemed the best place to start to get the message out and gain new objective data about the real picture and issues affecting children”. Ms Webb said.

204 children from 1 Comprehensive and 2 Junior schools in Neath/Port Talbot locality completed a questionnaire which included questions on risk factors predisposing children and young people to back/neck pain (School bag weight, school furniture, general lifestyle, previous back pain). The children ranged from 7-15 years (in years 3-6, 7 10).

Analysis of the data identified that children are having back pain, yet they shouldn’t be. There is significant under-reporting and currently lifestyles are quite alarmingly, not conductive to good musculoskeletal health.

Results alarmingly showed that 72% of primary children (aged 8-11) had suffered back and/or neck pain in the past year and 36% in the past week. Top 5 Activities causing discomfort were: sitting in assembly (nearly 40%), sitting on the floor, sitting at school desk, sitting on school chairs and working at computer (closely followed by carrying equipment).

61% of Year 7’s surveyed and 71% of Year 10’s experienced back and/or neck pain within the last year and 26% and 44% in the last week respectively. Top 5 activities affecting secondary aged children were: carrying school bags, sitting on school chairs, sitting at school desk, sitting in assembly and working at computer.

Interestingly, primary aged children suffered more neck pain than back pain (maybe from over-extending their necks when sitting on the floor to look at a teacher. Year 10 (secondary) pupils experienced back pain more than neck pain.

89% of those questioned had not reported their back/neck pain to a GP or physiotherapist. This shows a huge under-reporting of the issue.

Other study results: 15% of the Year 7 sample carried a bag greater than the recommended 10% of their body weight. 51% of the Year 10 sample watched TV/DVDs or played computer games for 2-4 hours every day after school. It is quite likely poor, unhealthy postures will be adopted during this time, again contributing to the risk of back and/or neck pain. Education about healthy posture and ergonomics can be applied at school and home.

29% of all pupils questioned exercised 5 times a week or more. Exercise and physical activity are essential for good spinal health as the muscles which support the spine need to be strong and flexible to allow correct movement and posture.

78% of pupils surveyed would like teaching on how to keep their backs healthy.

Following this analysis, a pilot school-based back health education programme “Back on Track” has been developed. It covers factors which can cause a sore back – school bags, sitting, lifting/carrying, posture/ergonomics and re-enforces why exercise and healthy eating are important. PSHE co-ordinator, Samantha Bray said “the programme has been really well received by our pupils. Most notably, our students were shocked to find out that over half of their age group suffer back pain”.

Ms Webb has been presented the “Back on Track” programme concept to primary and secondary teachers in the Neath/Port Talbot locality as part of the Healthy Schools initiative and has been invited to present at the Primary Care and Public Health Conference at the NEC in May.

Following the pilot study, a feedback questionnaire and quiz will help glean what pupils have learnt, if it has been of benefit and gain feedback from staff about developing the programme further to run alongside other topics on the PSHE curriculum.

In the meantime, Ms Taylor and Ms Webb have produced a “Top Tips to Keep Your Back on Track” postcard for children, parents and schools on why back health is important for youngsters, posture, lifting and carrying, packing and carrying school bags, the importance of keeping active, hydrated and eating healthily, sitting comfortably and workstation ergonomics.

For more information contact: Lorna Taylor on 0115 7140055 or 07432 659395 email lorna@jollyback.com or Helena Webb on email Helena.webb@wales.nhs.uk

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