Backpacks and back pain in children

Each school year millions of children walk to, from and around school carrying backpacks filled with books and materials. Parents should be aware that overly stressing the back with a heavy backpack could cause back pain in their child. Following a few guidelines and using common sense can help avoid this type of back pain.

How the back responds to the backpacks
Using a backpack allows a person to carry more items than would be possible by the arms and hands alone. The risk, however, is overload, which can strain the back, neck or shoulders.

The back will compensate for any load applied to it for an extended period of time. A heavy weight carried in backpacks can:

• Cause a person to lean forward, reducing balance and making it easier to fall

• Distort the natural curves in the middle and lower backs, causing muscle strain and irritation to the spine joints and the rib cage

• Cause rounding of the shoulders

Habitually carrying backpacks over one shoulder will make muscles strain to compensate for the uneven weight. The spine leans to the opposite side, stressing the middle back, ribs and lower back more on one side than the other. This type of muscle imbalance can cause muscle strain, muscle spasm and back pain in the short term and speed the development of back problems later in life if not corrected. The weight can also pull on the neck muscles, contributing to headache, neck pain and arm pain.

Medical research on backpacks
A review of the medical literature on this issue shows inconsistent recommendations on how to avoid episodes of back pain in children who carry backpacks. However, the literature currently suggests there is little chance a child will be permanently injured by carrying a heavy backpack.

• Several authors suggest limiting the backpack weight to 10-15% of the child’s body weight is reasonable. These authors acknowledged that this recommendation is not based on scientific research.

• One article found no correlation between backpack weight and back pain, and the authors were unwilling to recommend a backpack weight guideline for children.

• Another article investigated the correlation between spinal deformity and how the child wears the backpack. They did not investigate whether children who carry heavy packs are more likely to experience long term spinal deformity.