“Back” to School – 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. 

Backpacks allow 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 on the back can:

• Cause a person to lean forward, reduce balance, and make it easier to fall.
• Distort the natural curves in the middle and lower back, causing muscle strain and irritation to the spine joints and rib cage.
• Cause rounding of the shoulders.

Habitually carrying a load 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.

Following a Few Guidelines can Help Avoid this type of Pain:

• It is important to use both shoulder straps. Wear the backpack properly.  Keeping the weight close to the body helps the spine stay aligned and evenly distributes the weight on both shoulders.
• Tighten the shoulder straps so that the backpack is sitting right at the hip. If the pack hangs down below the hips, it will pull down and cause pain in the shoulders and upper back.
• Keep the weight at 10 to 15 percent of your child’s body weight. Example:  if your child weighs 100 lbs., the backpack should weight no more than 15 lbs.; preferably 10 lbs. 

Back pain is more common in older adolescents, especially with heavy backpacks, but younger children can also experience pain. If the pain persists after you lighten your child’s backpack load or if the pain is severe, this may be sign of spondylolysis, spondylolisthesis, or disc herniation.  It is advised that you have your child evaluated by a pediatrician, family doctor, or orthopaedic spine specialist to be sure there is no other cause.