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Backpacks Hurt Children’s Spines

Renee Despres
Friday, June 15, 2012 - 20:32

Are we setting our children up for a lifetime of back pain? While parents and children have long expressed concern about the heavy loads children often carry to school, camp, and other activities, few studies have documented physiological changes that occur when children are wearing backpacks. Back in February, a study reported in Spine suggested that the link between children’s back pain and backpacks might be stronger than previously thought. Investigators found that even moderately heavy backpacks may cause compression of spinal discs and spinal curvature in children, which, in turn, may lead to back pain. The research team, led by Timothy B. Neuschwander, M.D. in the Department of Orthopaedic Surgery, University of California, San Diego, CA, said theirs was the first upright MRI study to document reduced disc height and greater lumbar asymmetry for common backpack loads in children. Translate: They were able to measure problematic changes in children’s spines when the children wore backpacks, and the changes grew worse as the backpacks grew heavier.

Neuschwander and colleagues used an upright magnetic resonance imaging (MRI) machine to examine the lower back (lumbar spine) of three boys and five girls aged 9 to 13 years. First they examined the children while they were standing but not carrying anything; they then repeated the scan with the kids wearing backpacks that weighed 4, 8, and 12 kg (about 8, 17, and 25 pounds, respectively). Investigators measured disc compression and increases in curvature of the lower spine and found that both increased dramatically with backpack weight.

Although the study was small, involving only eight kids, it’s worth paying attention to when you’re sending your little treasures off to their day’s activities. More than 92 percent of children in the United States regularly carry backpacks loaded with 10 to 22 percent of their body weight. Thirty-seven percent of children aged 11 to 14 years report back pain, and most of them link their pain to wearing a school backpack.

While children in the study wore their backpacks on two shoulders, those who sling over one shoulder might experience even worse spinal curvature, said researchers. In addition, previous studies in children carrying 10%, 20%, and 30% of their body weight indicate that pressure under backpack straps is also a problem that causes significant pain.

What can a concerned parent do when little Jimmy insists on wearing that backpack because everyone else is wearing one, or when teachers send him home with five weighty textbooks? There’s no perfect solution, but here are some suggestions:

  • Limit the load in your child’s backpack to no more than 10 percent of his or her body weight. For instance, a 15 kg (50 pound) child should carry a pack that is no more than 2.5 kg (5 pounds).
  • When purchasing a backpack, look for wide shoulder straps with good padding and a hip belt.
  • Teach your child how to load and use a backpack properly. Backpacks should be properly adjusted and worn over two shoulders, with the a hip belt fastened snugly. The load should be distributed with the greatest weight at the bottom of the pack and lighter items on top.
  • Avoid messenger type bags that are slung over one shoulder.
  • Find ways to lighten your child’s load. For instance, you may be able to keep an extra set of textbooks at home or use electronic media to access textbooks.
  • Remember that not all children’s back pain can be attributed to back packs. If your child does complain of back pain, seek expert evaluation. Back pain may be a sign of a more serious problem, such as spondylolysis, spondylolisthesis, disk herniation, a sports injury, or a tumor or infection. If back pain is caused by another problem, that’s all the more reason to lighten or eliminate your child’s backpack load.