How Backpacks Affect the Adolescent Spine

Back pain that affects the adolescent spine is considered to be a precursor to adult chronic low back pain.  Over 90% of children in the United States carry backpacks, therefore, it is imperative, that they are instructed on proper backpack use, as carrying backpacks incorrectly at a young age could lead to long term back pain issues. More than 60% of adolescents ages six to nineteen, reported back pain associated with backpack use according to a clinical study printed in The Spine Journal Volume 16 (2016)1.  This particular study found the amount of time students spent carrying backpacks and the position of the backpack played a key role in back pain.

Additionally, a separate study printed in SPINE Volume 35, Number 1, pp 83–88 ©20092, showed the weight of backpack loads is responsible for a significant amount of back pain in children. The study discovered that carrying heavy backpacks can cause compression of the spinal discs, especially in the lower spine.  As backpack weight was increased, children had to adjust their posture to bear the heavier loads, thus causing increased forces on the discs, leading to low back pain. The study stated that a significant amount of back pain may be due to changes in lumbar disc height or curvature resulting from the backpack load. These changes were noted in the lumbar spine MRI scans of the participants while standing with backpack loads at 10%, 20% and 30% of the body weight. It is our belief that changes in the lumbar disc height are typically due to torn, leaky discs caused by wear and tear, thus leading to degenerative disc disease.

If you have a school-age child that carries a backpack, the American Occupational Therapy Association recommends that a child’s backpack should weigh no more than about 10% of his or her body weight. This means a student weighing 100 pounds shouldn’t wear a loaded backpack heavier than approximately 10 pounds. Backpack weight should be distributed evenly by using both straps. Wearing a backpack slung over one shoulder can cause a child to lean to one side, thus curving the spine and causing increased forces on the discs, leading to pain and discomfort. Shoulder straps should be well-padded, and the bottom of the backpack should rest in the curve of the lower back. It should never rest more than four inches below the child’s waistline. Being aware of these simple guidelines can help our youth avoid becoming a chronic low back pain statistic.

The following photo is taken from The Effect of Backpacks on the Lumbar Spine in Children, A Standing Magnetic Resonance Imaging Study printed in  SPINE Volume 35, Number 1, pp 83–88 ©20092. The photos show an example of lumbar asymmetry. The image on the left shows a child standing with no backpack load. The image on the right shows a child with a 17-pound backpack load in the standard, 2-strap position.


1. The Spine Journal Volume 16 (2016)

2. SPINE Volume 35, Number 1, pp 83–88 ©2009

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