By: John J. Triano, DC, PhD
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.
Using a backpack allows a child to carry a number of schoolbooks and items in a practical way, distributing the heavy load across the strong back and shoulder muscles. 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:
- Distort the natural curves in the middle and lower backs, causing muscle strain and irritation to the spine joints and the rib cage
- Lead to rounding of the shoulders
- Cause a person to lean forward, reducing balance and making it easier to fall
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.
A heavy backpack can pull on the neck muscles, contributing to headache, shoulder pain, lower back pain, and/or neck and arm pain.
Medical Research on Backpacks
While the medical literature on backpacks is often inconclusive, and sometimes contradictory, a review of current medical literature suggests several general conclusions:
- Carrying heavy backpacks, or carrying them in a way that strains the back, is a frequent cause of back pain in children and adolescents
- The back pain caused by back packs is short term (e.g. muscle strain) and alleviated with a short period of rest or reduced activity; any type of back pain that persists is uncommon and should be evaluated by a medical professional
- 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
- There is no evidence that structural spinal deformity can result from backpack use1
- There is little chance a child will be permanently injured by carrying a heavy backpack
References: Cottalorda J, Bourelle S, Gautheron V, “Effects of Backpack Carrying in Children,” Orthopedics, Nov 2004 (vol 27:11 p.1172-5)