Are Backpacks to Blame for Back Pain?

Children's Heavy School Backpacks May Only be Part of the Problem

From the WebMD Archives

June 18, 2003 - Children may complain about their heavy backpacks, especially during school, but are they really responsible for back pain? A new American study says yes, but a similar study from the Netherlands says no and argues that some children's back pain may be all in their heads.

The issue of heavy school backpacks and their role in back pain has received a lot of attention in recent years. But it's still not clear whether the burden of these heavy loads actually causes back pain in children.

And that question probably won't be answered definitively anytime soon as shown by two new conflicting studies in the May 1 issue of Spine.

In the American study, researchers from the Alfred I. duPont Hospital for Children in Wilmington, Del., and the Johns Hopkins School of Public Health, surveyed over 1,100 students between the ages of 12 and 18.

They found 74% of school backpack users reported back pain. The children with back pain also reported significantly poorer general health, more limited physical functioning, and more bodily pain.

How Much Is Too Much?

The average weight of the children's school backpacks was 18 pounds, or about 14% of the students' body weight. Researchers found that compared to children without back pain, those with back pain reported carrying heavier backpacks that represented a higher percentage of their body weight.

Previous studies have shown that children carrying school backpacks exceeding 10% of their weight are more likely to lean forward -- potentially increasing the risk of back pain in children, say the researchers.

Children who reported back pain were also more likely to be female, older, and overweight. The researchers say children that attended schools that didn't allow students to carry backpacks between classes were less likely to report back pain.

In the Dutch study, researchers from the regional health center in the Netherlands and VU University Medical Centre in Amsterdam, evaluated neck, shoulder, and back pain in 745 secondary school students.

The researchers found about 45% of the students reported pain in those body areas.

But researchers found the weight of the children's school backpacks was not related to pain complaints, even though the average weight of the children's backpacks was heavy, at about 17 pounds or 15% of their body weight.

Is It All in Their Head?

Instead, psychosomatic factors such as general listlessness, tiredness, and stress-related headaches were more strongly related to back, neck, and shoulder pain complaints.

In addition, the researchers found that students that perceived their school backpacks as heavy were more likely to have back, neck or shoulder pain, but the actual weight of the backpack was not a factor.

Regardless of their findings, researchers say both studies highlight the fact that a large number of children and teens report back pain, and more studies are needed to determine the factors that increase the risk of neck, shoulder, and back pain among children.