Phones have revolutionized our lives and infiltrated all spheres of our life from education to recreation to vocation. It is more than just a means of communication; it has become an inseparable part of our life- like an appendage attached to our bodies. However, smartphones have also become a reason for specific health concerns, including those that can affect our spine health. The slouch posture we use during smartphone use only adds to the stress on our spines due to overuse. In this article an outline of the spine issues due to smartphone use is discussed.

On an average the human head weighs approximately 10to 12 pounds of pressure, so rather it’s a heavy force our neck is designed to carry. The weight transferred to our spine via the neck also increase progressively in relation to the tilt angle of our neck. It has been shown that the more we lean forwards higher the equivalent forces transferred to our neck. For example, if we lean forward to an angle of around 60 degrees (as we do sometimes while we slouch on our phones) the weight transfer forces can increase up to 60 pounds. Roughly, pressure of around 10 pounds is transferred to our shoulders for every inch our head is tilted forward.

These forces are specifically transferred via our tendons, ligaments, muscles and the intervertebral discs (Shock absorbing cushions between the bones of spine). These structures take on the damage of the forces transferred over time. Most of us tend to slouch while using our phones subconsciously as our posture becomes involuntary with time. This form of unnatural slouching posture puts considerable strain on the structures of our neck and low back. These forces are particularly harsher when such posture is maintained for longer durations and consistently over longer periods of time. Our posture is more than just aesthetics. Good posture is protective shield against pain also. Poor posture due to constant and improper use of back and neck pain, can be a significant cause of disability.

Over longer periods, during our lifetime such poor posturing can lead to a plethora of other problems beyond our spine. These include Carpal Tunnel Syndrome (may lead to disabling pain, tingling and numbness in the fingers and palm of the hand), heart burn(acidity), circulation complications over longer time can lead pain in knees and other joints too. Digestive problems can also be attributed to hunched posture as our internal organs are squeezed into smaller space owing to hunching. In elderly with an already hunched spine, hunched posture can affect breathing also. Slouched posture while reading books as effects similar to slouched using of smartphones.

The above information helps us to make intelligent choices regarding our smartphone use It is advisable to take frequent breaks from excessive use of screens, be it smartphones or computers. It is easier said than done for professionals working on computers. For such professionals it is advisable to   pay strict attention towards proper posture. An ideal spinal posture is one where spine is not slouching, adequate back support is there for your lower back, the screen is at the level of your eyes (if its smartphone- holding it up to the eye levels) and the posture is frequently changed. Simple stretches out of the chair should be practised every half an hour to one hour. Smartphones are definitely a boon, its in our hand not to run into a curse. Little attention to our posture, can go a long way in avoiding the curse. All the best.

Infections of the spine are relatively rare compared to other spine conditions like slip disc. But if a spinal infection happens, it can cause significant damage which can cause paralysis or sometimes even be life threatening if not treated at the earliest. Spinal infections can affect the bones (vertebrae), the discs (cushions between the bones) and the fluid or the soft tissues in and around the spine.
Back pain or tender back is the usually the first presentation of spinal infection. However not all back pains are caused due to infections. The symptoms which when associated with back pain can serve as indicators of infections are: Back pain which is severe at night, fever and chills, Sudden mobility limitation with severe muscle spasms, accompanying headaches, weight loss, pain or difficulty while urinating, abdominal pain. Some spinal infections can also cause neurological problems. Symptoms of neurological issues related to a spinal infection may include loss of balance, weakness, vision changes, or an inability to speak, numbness and the inability to move, walk, stand or sit.

Causes

Spinal infections are usually caused by bacteria. Occasionally associated with other organisms like fungi. Infection from other parts of the body can reach the spine via blood stream or infection can directly reach the spine by direct spread. Urinary tract infections or chest infections (like pulmonary tb) can spread to the spine. Once it reaches the spine infection commonly affects the spinal discs. Once discs are involved, they begin to erode and collapse, with gradual spread of infection to other structures in spine, which results in back pain due to the inflammation. When the infection reaches the nerves and starts pressing on the nerves, it can result in weakness of the legs or arms with shooting radiating pain like sciatica.
Other predisposing factors for spinal infections include conditions which result in decreased immunity like prolonged steroid use, advanced age, HIV, intravenous drug use, cancer, malnutrition and diabetes.

Diagnosis

Blood tests and imaging (radiology play a major role in diagnosis of infections. Blood tests include – Complete Blood count, ESR and CRP. Imaging studies include x-rays, MRI and CT scans. MRI is the most important investigation in characterisation of infection. Use of contrast injection (given in veins of the patients) helps in better delineation and identification of infection in MRI. CT scans help in identifying the amount of bone destruction, which in turn helps in surgical planning if indicated. Biopsy is one of the key components of spine infection diagnosis. Biopsy is a procedure of collecting sample of the infection tissue for diagnosis. Biopsy can be done by open method in operation theatre or under CT guidance under local anaesthesia in the radiology room. Biopsy helps to identify the type of bacteria and also helps to rule out some cancer which can present very similar to an infection. One of the problems with biopsy, is the result can come out negative, needing a repeat biopsy procedure in some instances.

Treatment

Both surgical and non-surgical methods can be used for treatment of spinal infection based on the individual case. If there is no imminent or present danger to the structure of spine and the function of the nerves, antibiotics based on the culture reports of the biopsy are the usual line of treatment. In more extensive cases where the structure of the spine sis damaged or the nerves are in danger or already damaged – surgical evacuation of infective pus with stabilisation becomes the option. If a spinal infection can be treated using non-surgical methods, a patient is usually started on an antibiotic or anti-fungal therapy. This is often conducted through a long-term intravenous treatment and possibly extended hospital stay. If non-surgical treatments fail to control the infection, or it’s determined that the infection is too deeply involved in the spine, then also surgery will be needed. The surgery is meant to remove the infection and clean the affected area. Surgical intervention can also permit a closer look that will ensure all of the infection is removed, plus allow better blood flow to the affected areas and stop any further neurological damage.
Though it is true that all back pains are not infections, it is true that all back pains need to be evaluated to by spine health expert due the impact which back pain can have if caused by more sinister diagnosis. It is important to remain vigilant about such back pains as described in the blog and meet the nearest spine surgeon or spine specialist at the earliest.