Prolonged use of screens is one of the risk factors for spine health, shows study financed by the State of São Paulo Research Foundation (Fapesp) and published in cientific magazine Healthcare. 
Among the risk factors is the use of screens for more than three hours a day, the short distance between the electronic equipment and the eyes, use in the prone position (on your stomach) and in the sitting position. The focus of the study was the so-called pain in the middle of the back (thoracic back painor TSP).
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A total of 1,628 students of both sexes between 14 and 18 years old, enrolled in the first and second year of high school during the day, in the urban area of the municipality of Bauru (SP), who answered a questionnaire between March and June 2017 were evaluated. .
Of these, 1,393 were reassessed in 2018. The survey found that of all participants, the one-year prevalence was 38.4%, meaning that adolescents reported TSP in both 2017 and 2018. The one-year incidence was of 10.1%; that is, they did not notify TSP in 2017, but were referred as new cases in 2018. Back pain occurs more in girls than in boys.
“The difference between the sexes can be explained by the fact that women report and seek more support for musculoskeletal pain, are more exposed to physical, psychosocial and stress factors, have less strength than men, have hormonal changes resulting from puberty and low levels of physical activity”, says one of the authors of the article, Alberto de Vitta, doctor in education from the State University of Campinas (Unicamp) with a postdoctoral degree in public health from the São Paulo State University (Unesp) in Botucatu.
Pandemic
TSP is common in different age groups in the world’s population. It is estimated to affect 15% to 35% of adults and 13% to 35% of children and adolescents. With the covid-19 pandemic, children and adolescents have been using cell phones, tablets and computers for a longer time, either for school activities or for leisure. As a result, it is common for them to adopt inappropriate postures for a long time, causing pain in the spine.
Time spent with electronic devices (for example, watching television, playing video games, using computers and smartphones, including electronic communications, e-games, and the internet) can be classified as follows: low (less than 3 hours/day), medium (above 3 hours/day to 7 hours/day) and high (above 7 hours/day), considers the researcher.
According to De Vitta, it is possible that the incidence of TSP has increased with the pandemic, but there are still no studies. “We can assume that it has increased, due to school activity at home, however there is no data on this. We are organizing a multicenter study that will be carried out in cities in São Paulo, Minas Gerais, Goiás and Rio Grande do Sul”, informed the researcher, who currently teaches and researches in the Department of Physiotherapy at Faculdade Eduvale de Avaré (SP) and in the program in Education, Knowledge and Society at the University of Vale do Sapucaí (Pouso Alegre, MG).
Factors
TSP can be treated, says the professor. “There are several types of treatments such as, for example, global postural re-education, pilates and physiotherapy based on electrothermophototherapeutic resources: ultrasound, laser, among others”.
Physical, physiological, psychological and behavioral risk factors or a combination of them may be associated with TSP. “Musculoskeletal pain, such as in the thoracic, lumbar and cervical spine, is multidimensional”, explains the researcher.
“Physical factors (inadequate desks, backpacks weighing more than recommended and others), behavioral factors (using electronic equipment for more than three hours a day, inadequate posture) and mental health factors (emotional symptoms, stress, etc.) these pains”.
The combination of physical and behavioral factors generates an increase in the compression force of the intervertebral discs, leading to malnutrition of the discs, compromising the integrity of the musculoskeletal system, predisposing the individual to fatigue and higher levels of pain.
“There seems to be a relationship between emotional symptoms and physical manifestations, such as increased secretion of the hormone cortisol and changes in the hormonal regulation of the adrenal glands, which generate inhibitory effects on the immune system, digestion and symptoms of excessive body wear, tiredness. , fatigue, muscle and joint pain. All these factors were related to our research data related to low back, neck and thoracic pain in high school students”.
Early puberty
Puberty is a natural state of the human body which, as a result of hormonal changes, tends to appear from the age of 8 in girls and 9 years in boys.
However, children are entering this phase earlier and earlier. Weight gain, excessive consumption of ultra-processed foods and a sedentary lifestyle are among the main causes. But another factor has drawn the attention of researchers.
According to the result of a search presented during the 60th Annual Meeting of the European Society of Pediatric Endocrinology, precocious puberty may be being stimulated by high exposure to screens, such as tablets and cell phones.
“Studies show that blue light from screens decreases the production of melatonin, a hormone related to the sleep cycle. Less melatonin production can be a signal to the body that it’s time to enter puberty. In addition, weight gain and anxiety that may be associated with excessive use of screens also alter the production of certain hormones such as leptin and serotonin, which can lead to puberty at an early stage”, explains the endocrinopediatrician at Sabará Hospital Infantil, Paula Baccarini.
The expert says that, due to isolation during the pandemic period, children began to eat less healthily, generating other side effects that also alter hormones: “Stress and anxiety are also factors that can accelerate the onset of puberty , added to the sedentary lifestyle, the worsening of the eating pattern and weight gain”, he adds.
Routine
Ideally, the child should maintain a routine with healthy living habits, with physical activity, adequate sleep and natural food, with reduced consumption of industrialized products, which naturally already reduces free time for screen use, advises the doctor. “It is important to remember that the child learns from the example of the parents. So, it is essential that screen time control belongs to the whole family and not just to the child,” he adds.
Other activities can help reduce this time. “Create routines such as reading habits, recreational games, board games, drawing, puzzles. In addition, using the weekend to gather the family outside the house, if possible in contact with the sun and nature can help”, suggests the endocrinopediatrician.
If parents identify signs of precocious puberty – such as the appearance of breast buds, development of pubic hair, accelerated growth, acne, they should look for a pediatric endocrinologist to make the diagnosis, identify the cause and assess the need for treatment.
“Treatment is indicated in cases where puberty occurs early or evolves at a very fast pace, with a risk of the first menstruation occurring early or of growth arrest occurring before the expected age, with the prospect of the child growing less than the genetic prediction. . It consists of a hormonal treatment that blocks the production of these hormones associated with the development of puberty”, explains the specialist.
Once puberty begins, there is no way to reverse the condition, just treat it with pubertal blockade when indicated, points out the doctor. “Therefore, the importance of establishing healthy lifestyle habits during childhood, as a way of trying to reduce the risk of puberty occurring early. It is important to say that these changes in lifestyle habits are also related to the reduction of other conditions, such as obesity”.
Puberty that appears before 8 years of age in girls and 9 years of age in boys is considered precocious; and delayed, puberty that begins after age 13 in girls and after age 14 in boys.
The doctor considers the risk of advancing menstruation and premature growth arrest, with damage to the child’s final height, in addition to the psychosocial risks associated with precocious puberty. If necessary, she will prescribe treatment to temporarily block pubertal development.
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