Backpacks and Back Pain

The children were asked a number of questions related to back pain while carrying backpacks to and from school and also during school holidays. They were also asked how they carried their packs - symmetrically with straps over both shoulders or just with one strap over one shoulder.

Some of the findings were

• Carrying a backpack on one shoulder causes the student to lift the carrying shoulder and shift the body in the other direction.
• Students who carried backpacks over one shoulder were more than four times as likely to suffer from high intensity pain than students who carried packs symmetrically.
• There was no relationship between time spent carrying backpacks and back pain during school terms. However there was significant correlation between time spent at school and back pain during the school holidays which may be associated with a "delayed response" to stresses faced by the spine during school terms.

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Other studies have shown that back pain at an early age can significantly contribute to an individual experiencing back pain as an adult. As such, the importance of proper backpack use, especially amongst children should not be underestimated.

Tips for Using Backpacks
Always use correctly. As the study showed carrying packs over just one shoulder has significant issues for back pain. Always use both straps over both shoulders and pack the heaviest items closest to your back.
Limit your backpack load. The recommended maximum load for a backpack is no more than around 10-15% of body weight.
Plan your homework. Plan ahead and spread homework out over the course of the week so you won't have to carry all your books home at one time.
Use a well constructed pack. Make sure that the pack you choose has two padded straps to go over the shoulders (the wider the straps, the better). A backpack with a waist belt can helps to distribute the weight more evenly around the body and multiple compartments can also help even out the weight distribution of the load.
Strengthen your core. A great way to prevent lower pack pain and injury is to strengthen the stabilising muscles of the core of your body (particularly abdominal and lower back muscles). Pilates, yoga and targeted weight training can all assist in achieving this.

(1) Korevessis P, Koureas G, Zacharatos S, et al. Backpacks, back pain, sagittal spinal curves and trunk alignment in adolescents. Spine 2005;30(2):247-255.

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