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Writer's pictureDr. Kendra Becker

Backpacks or Back Pain?

Updated: Jan 14, 2020


If a backpack is carried improperly or is excessively heavy, it can result in the severe back and neck pain, neck or back injury, poor posture and generalized fatigue.  Excessively heavy back packs may harm muscles and joints as well, compounding, serious fatigue to the child’s body.  Though books are essential for learning, carrying them, should not affect physical well being..

Heavy backpacks may be more than just an annoyance for students.  Studies show an overloaded backpack forces the child to compensate by leaning forward to balance the load, creating potential health problems if the backpack is over weighted and hanging too low. This action can cause kids to hunch forward, putting an awkward strain on the shoulders, spine, and muscles.  This is no laughing matter, it has been reported that most students in The US carry school backpacks.  Stress and strain to their bodies resulted in over 7,000 emergency room visits in 2006 and approximately half of the injuries reported occurred in children 5 to 14 years old.  NPR reported that over 65% of all adolescents’ visits to a health care provider were due to back pain.

According to a study conducted by UC Riverside, the prolonged strain of the backpack weight can result in long term injuries. The study involved 3,500 students between 11 and 15 years old.  64% of the students reported back pain and 21% said that the pain lasted for more than six months.  Another recent study found that backpack use significantly altered head-on-neck posture in every age group studied. This finding was most pronounced in younger students.  In a survey of the orthopedists, 58% had said reported seeing patients complaining of back and shoulder pain caused by heavy backpacks. More than 70% of the orthopedists surveyed indicated that heavy backpacks can become a clinical problem in school-age children if not enough attention is made to decrease some of the weight being carried in the packs. Research tells us that the earlier children are diagnosed with back pain the longer in life they are affected.

As a rule the total weight of a backpack should not exceed 10-15% of a child’s total body weight.  So if your child weighs 50 pounds their backpack should not weigh more than 5-7 pounds- that includes the backpack and all of its contents.  Parents can also teach their kids to carry the backpack correctly, by using both the straps.

To reduce injuries or pain resulting from back packs, students can increase muscle strength and endurance, making back pain is less likely. Purchasing a backpack that has straps that go around the hips to keep the weight away from the back, also help balance the “load” and distribute the weight more evenly and also reduce injury. Backpacks should never hang more than four inches below the child’s waistline. Backpacks should be smaller than the child’s back. Straps should be padded and used at all times to avoid an uneven pull on the back.Proper positioning of a backpack is in the center of the back. Adjust the straps and use the middle waist belt if available to keep the backpack from hanging too low. It should rest between or below the shoulder blades. Using a chest strap helps distribute the weight evenly across the back.  Packs should not go below the lumbar spine.

Some easy and practical tips to reduce injury are:

1. Keep extra books and notebooks at home.  So there is no need to lift extra weight.

2. Always wear backpack on both the shoulders. Carrying backpack on one shoulder can put the pressure on one side of the body and can cause injury.

3. Wear both straps of the backpack at all times, this distributes the weight load evenly so well aligned posture is encouraged and facilitated.

4. Avoid carrying backpack for a long time.

5. If the backpack is very heavy, use the belt that will save from back problem.

6. Buy a backpack with wide well padded straps, and a chest strap that can distribute equal loads.

7. Use the bag with wheels if backpack is too heavy.

8. Avoid buying a backpack that in itself has a lot of weight.

9. Encourage kids to use lockers at school if available.

10. Lobby for less homework so books can stay at school.

11. Visit your local Chiropractor for wellness checks and symptom management.

12. Watch body mechanics putting on and taking off the backpack. Avoid twisting and bending together at the waist. Swinging the weight to get the backpack on is a sign it is too heavy.

13. Weigh backpacks regularly and “clean them out” often to avoid carrying additional unneeded weight.

The American Occupational Therapy Association has named September 19 as National School Backpack Awareness Day.  This organization educates communities on proper backpack ergonomics. The theme is, “Pack It Light, Wear It Right!”  Back to school is a fun and exciting time in a child’s life…make is a safe and pain free one too.

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