US troops 'vulnerable to back pain'

[[R_H]]

BBC

US soldiers in Iraq and Afghanistan are more likely to be withdrawn from the battlefield due to back or joint pain than combat injuries, a study says.

A survey in a UK medical journal of US evacuees treated at a military hospital in Germany from 2004 to 2007 shows that psychiatric disorders also increased.

The study, in the Lancet, looked at the injuries suffered by 34,000 US military personel in Iraq and Afghanistan.

It found only 14% percent of medical evacuations were due to combat wounds.

Back, joint and muscle pain were instead the leading medical problems suffered by soldiers, accounting for almost one-quarter of all injuries.

The analysis, carried out by researchers at the Johns Hopkins School of Medicine in Baltimore, said the bulk of the other evacuations were also caused by everyday medical problems like gastro-intestinal infections, respiratory diseases, chest and spinal pain.

But they also noted that the rate of psychiatric problems was increasing sharply - almost tripling in Iraq over the course of the study to 14%, and nearly doubling in Afghanistan, to 11%.

Non-combat injuries also caused most of the American medical evacuations during the wars in Vietnam and Korea.

But this study is prompting the US Department of Defence to look at the weight of equipment that soldiers are routinely required to carry, and the length of their tours of duty.

It's interesting that the every day problems, which are causing most of the evacuations, can't be treated in the theater. Is it because a lack of medical resources, or because it's easier to treat them outside of Afghanistan?

[Spyder]

BBC

It's interesting that the every day problems, which are causing most of the evacuations, can't be treated in the theater. Is it because a lack of medical resources, or because it's easier to treat them outside of Afghanistan?

I imagine anything that reduces mobility probably takes some time to recover. Probably easier to send them back and bring in the fresh meat.

[Serafina]

Serious back problems, even if nothing is broken and you are doing a good rehab, can easily take three to six months to recover.
So yeah, it propably is easier to send them home, especially since being in a nicer enviorment will help a lot.

This propably holds true for a couple of other "normal" medical problems, and especially for psychiatric problems.

Now, the more interesting questions is:
Is the rate higher than in the civilian population, and what are the causes?
Soldiers will of course suffer from the same problems than civilians - bodyarmor does not protect from digestive problems
That's pretty normal for armies all over the world - but at least in the case of back problems, i can easily imagine that the heavy equipment takes it's toll.

[Zixinus]

But this study is prompting the US Department of Defence to look at the weight of equipment that soldiers are routinely required to carry, and the length of their tours of duty.

Hence why every proper military tech designer has to have low-weight as a secondary priority (I would imagine the first is reliability). You can shift weight around with good harnesses and stuff, but in the end of the day, you'll have soldiers carrying several kilos of body armour (up to 5-10 kilos I imagine?) and other equipment than weaponry.

Seriously, this is an important issue: that is why every firearm company is switching over to plastics (from wood and metal) to lower the weight of their weapon (usually the difference can be less than a kilo!). I was told that this is also why soldiers' uniform switched to textile (artificial textile perhaps?) belts with plastic connectors from leather and metal ones.

Of course, I imagine that they load every saved gram with ammo rather than allow a soldier to have less back-pain from carrying all the stufy.

[Mr Bean]

Of course, I imagine that they load every saved gram with ammo rather than allow a soldier to have less back-pain from carrying all the stufy.

Or gadgets. This has been the military issue for the last hundred years. Every pound saved in improved harness and weapons is lost because they start using those lost pounds in others ways and every soldier is still walking around with seventy pounds on his back as his "light" load.

[Sea Skimmer]

It's interesting that the every day problems, which are causing most of the evacuations, can't be treated in the theater. Is it because a lack of medical resources, or because it's easier to treat them outside of Afghanistan?

US policy is any injury or illness that requires more then three days of recover is an evacuation out of the theater. That lets us keep our medical resources in theater ready to receive mass combat casualties at any time. No one is going to recover very well in Iraq or Afghanistan conditions knowing they might come under attack in a bed, and it’s pointless to just move a person into a place like Kuwait or Qatar when we already have military transport planes flying home mostly empty to Germany and the US.

My dads crippled for the rest of his life by a military related back injury, so I am not surprised by this at all. We just notice stuff like this more now because our combat losses are so low. Disease is causing a bigger proportion of our losses then it might have a few decades ago too.

[Simon_Jester]

Why so? Lower combat casualties?

[The Yosemite Bear]

Rush now hates vets due to them hogging all the Oxycoitin and vicadin.

[adam_grif]

Yep, modern soldiers carry a LOT of gear. And it ain't light, either.

[Sea Skimmer]

Why so? Lower combat casualties?

A lot lower. We pretty much lost people in the world wars to accidents at a higher rate then we suffer all accident-combat-disease losses in Iraq and Afghanistan now. This is because our current enemies are proportionally far weaker in numbers, firepower and technology, while we’ve made some pretty big leaps forward in personal protection. But the accident and disease rates don’t go down as fast as combat casualties in the face of a weak enemy, so they get noticed more. But hey, its still better then even 150 years ago when you might still expect 80% of losses to come from disease alone, and for most of those people to die and to have made up half your army.

[Aaron]

Serious back problems, even if nothing is broken and you are doing a good rehab, can easily take three to six months to recover.
So yeah, it propably is easier to send them home, especially since being in a nicer enviorment will help a lot.

This propably holds true for a couple of other "normal" medical problems, and especially for psychiatric problems.

Now, the more interesting questions is:
Is the rate higher than in the civilian population, and what are the causes?
Soldiers will of course suffer from the same problems than civilians - bodyarmor does not protect from digestive problems
That's pretty normal for armies all over the world - but at least in the case of back problems, i can easily imagine that the heavy equipment takes it's toll.

Normal day to day Army life is hard on your knees and back to begin with (over half the guys I was with suffer from back and knee pain), the constant PT and marching doesn't help things much. Add in the 120+ of crap that guys in Afghanistan carry around, the lousy terrain and heavy lifting (good luck finding a lifttruck in a FOB) and you've got a recipe for injuries.

[Sarevok]

Science fiction styled Powered armor is a futuristic and potentially shitty idea. In the interim is there any way to make soldiers lives easier ? Every year infantry is getting more armor, radios, electronics equipment etc. Does the army have to pause and stop issueing additional gear at one point ? Or can there be a solution to carrying all the variety of tools a 21st century soldier needs without breaking his back ?

[Fingolfin_Noldor]

Science fiction styled Powered armor is a futuristic and potentially shitty idea. In the interim is there any way to make soldiers lives easier ? Every year infantry is getting more armor, radios, electronics equipment etc. Does the army have to pause and stop issueing additional gear at one point ? Or can there be a solution to carrying all the variety of tools a 21st century soldier needs without breaking his back ?

There's nothing much one can do other than continuing the process of miniaturisation. The fact remains is that it's a very hostile environment, and the human body is often very fragile with regard to handling shock and stress.

[Starglider]

Or can there be a solution to carrying all the variety of tools a 21st century soldier needs without breaking his back ?

Well there's that neat robot pack mule project...

[Fingolfin_Noldor]

Or can there be a solution to carrying all the variety of tools a 21st century soldier needs without breaking his back ?

Well there's that neat robot pack mule project...

I doubt that sort of thing will survive without tonnes of spare parts. Which will probably necessitate more things to get them delivered.

[hongi]

Is the rate higher than in the civilian population, and what are the causes?

The answer is easy. Soldiers have to carry heavy loads for long periods of time. It's not surprising you get back injuries when you carry close to their own body weight in some instances.

[General Zod]

Science fiction styled Powered armor is a futuristic and potentially shitty idea. In the interim is there any way to make soldiers lives easier ? Every year infantry is getting more armor, radios, electronics equipment etc. Does the army have to pause and stop issueing additional gear at one point ? Or can there be a solution to carrying all the variety of tools a 21st century soldier needs without breaking his back ?

There's been a few advances in independently powered exoskeletons, but they're still a ways off from being standard issue gear.

[Serafina]

Is the rate higher than in the civilian population, and what are the causes?

The answer is easy. Soldiers have to carry heavy loads for long periods of time. It's not surprising you get back injuries when you carry close to their own body weight in some instances.

Ok, let me reformulate that:
What can be done against it?

Exoskeletons are the lazy mans answer, but actually reducing the amount of gear, making it more lightweight or changing the way it is carried (thereby reducing the stress for joints and backbone) are certainly also possible solutions.
Furthermore, it certainly is possible that you could require the soldiers to make specialized exercises for about 30/60 minutes each day to counter the stress caused on their body, or at least alleviate it.

[General Zod]

Is the rate higher than in the civilian population, and what are the causes?

The answer is easy. Soldiers have to carry heavy loads for long periods of time. It's not surprising you get back injuries when you carry close to their own body weight in some instances.

Ok, let me reformulate that:
What can be done against it?

Exoskeletons are the lazy mans answer, but actually reducing the amount of gear, making it more lightweight or changing the way it is carried (thereby reducing the stress for joints and backbone) are certainly also possible solutions.
Furthermore, it certainly is possible that you could require the soldiers to make specialized exercises for about 30/60 minutes each day to counter the stress caused on their body, or at least alleviate it.

Lazy man's answer. . .what? How the fuck are exoskeletons a "lazy" solution given the amount of research that's being put into them? You can only shift the gear around so much after all.

[Serafina]

Lazy man's answer. . .what? How the fuck are exoskeletons a "lazy" solution given the amount of research that's being put into them? You can only shift the gear around so much after all.

With "Lazy Man's answer", i meant an answer that pretty much anyone can come up because it comes to mind more or less immedeately.
"Lazy" is reffering to the amount of thinking going into the answer, not into the difficulty of it's actual implementation.

It's like "how do we crack that fortress? We throw a nuke at it" - it works, it is not difficult to come to that solution, but it is not necessarily the only answer, the best one or even the easiest one to realize.
That's the case here - everyone talks about exoskeletons, but thats an "lazy answer".

[General Zod]

Lazy man's answer. . .what? How the fuck are exoskeletons a "lazy" solution given the amount of research that's being put into them? You can only shift the gear around so much after all.

With "Lazy Man's answer", i meant an answer that pretty much anyone can come up because it comes to mind more or less immedeately.
"Lazy" is reffering to the amount of thinking going into the answer, not into the difficulty of it's actual implementation.

It's like "how do we crack that fortress? We throw a nuke at it" - it works, it is not difficult to come to that solution, but it is not necessarily the only answer, the best one or even the easiest one to realize.
That's the case here - everyone talks about exoskeletons, but thats an "lazy answer".

You realize that by your own logic, "shifting the gear around" is equally lazy, because every single army since the dawn of time has been doing that? I also don't recall anyone suggesting it was the easiest to realize or the only answer.

[Aaron]

Ok, let me reformulate that:
What can be done against it?

Exoskeletons are the lazy mans answer, but actually reducing the amount of gear, making it more lightweight or changing the way it is carried (thereby reducing the stress for joints and backbone) are certainly also possible solutions.
Furthermore, it certainly is possible that you could require the soldiers to make specialized exercises for about 30/60 minutes each day to counter the stress caused on their body, or at least alleviate it.

Miniaturization could be an answer to things like radios, unfortunately it isn't quite as clear cut as that. The new series of radios the CF uses in the man pack role are about the same weight as the old 77 sets, even if the radio itself is smaller; thanks to the batteries.

The heaviest bits; body armour, rations and ammo aren't going to get much lighter without some significant advances in technology. Body armour requires a certain amount of ceramic and steel (+ kevlar) between the man and the round to get the protection the Army wants.

In the sort term, one could simply assign flat bed ATV's to each squad to carry the rucks, rations and bits of kit that aren't immediately required on your person. It'll still leave in excess of 70 lbs on folks.

[[R_H]]

Ok, let me reformulate that:
What can be done against it?

Exoskeletons are the lazy mans answer, but actually reducing the amount of gear, making it more lightweight or changing the way it is carried (thereby reducing the stress for joints and backbone) are certainly also possible solutions.

Pwwack animals or hand carts were used in WW2 (and earlier). The US Army used the M3A4 hand cart during the European campaign.

Furthermore, it certainly is possible that you could require the soldiers to make specialized exercises for about 30/60 minutes each day to counter the stress caused on their body, or at least alleviate it.

What kind of exercises are you thinking of?

[Aaron]

Donkeys and horses were used in the beginnings of Afghanistan. The hand cart is a great idea but I suspect it isn't high-tech enough for the US.Unless it can mount a million dollar missile, a GPS and a dozen other whiz-bang gadgets, they don't seem to want it. Sometimes I think the West is too much in love with gadgets for the troops own good.

[Sarevok]

What about rickshaw like cargo vehicles ? They can go anyplace bicycles can go at about roughly similar speeds. Beats pulling a cart by hand.

http://en.wikipedia.org/wiki/Rickshaw