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Backpacks May Not Cause Kids' Back Pain

Study Shows No Link to Backpack Use, Cites Inactivity as Possible Reason


To prevent back pain in children, both the AAOS and the American Academy of Pediatrics recommend that backpack loads not exceed 15% of total body weight, and that they always be worn using both shoulder straps and not slung over one shoulder.

But even if most children carry heavier backpacks than those studied by Haig -- who were observed toward the end of the school year, when loads tend to be lighter -- he says it shouldn't cause problems. "It is possible that a really big load or a really fragile child can combine to create back pain. More weight or longer distances mean your body should be in shape to handle the work. The backpack would be about the 10th thing on my list."

Instead, Haig says that to prevent back pain in children, parents should focus more on keeping children active. Exercise squeezes and stretches the disks that act as shock absorbers for the spine, pumping more nutrition and oxygen to keep disks healthy and pain-free, he says.

"We acknowledge the intuitive sense of parents, clinicians, and teachers that as children carry more in their backpacks, they have more back pain," he says. "But the increases in pain seem to be related to aging and inactivity. There is no evidence that backpacks cause anything more than temporary discomfort."

While most experts agree that exercise will build stronger backs, it doesn't mean that backpacks are unrelated to back pain in children, says Boden. "I just came back from the annual meeting of the International Society for the Study of the Lumbar Spine, which is probably the premiere international spine research group, and there were one or two studies suggesting that backpacks, in fact, do affect back pain in school kids."

He suggests children use backpacks with wheels so they can be rolled and not hauled. When carried, a full backpack should have heavier items closer to the child's back and evenly distributed; have padded, wide straps and a back and a hip strap for heavier weights; and be worn about two inches above the waist to help prevent back pain in children.


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