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Back Pain Health Center

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Backpacks May Not Cause Kids' Back Pain

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

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"A typical third grader weighs about 50 pounds, so 6% would be about 3 pounds, and since a middle school child usually weighs around 100 pounds, that is about 11 pounds in their backpack. You could balance three pounds of weight on your nose and it wouldn't matter," says Scott D. Boden, MD, director for the Emory University Spine Center and a professor of orthopaedic surgery at its medicine school. "I think those backpack loads are way low."

Two Italian studies indicate that children there typically carry about 30% of their body weight in their backpacks. "And I'm willing to bet that most kids here carry 15 or 20 pounds," Boden, spokesman for the American Academy of Orthopaedic Surgeons (AAOS), tells WebMD. It's these heavier weights that are often blamed for more than 13,000 back injuries in children each year that require medical treatment.

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."

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