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.

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