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  • Writer's pictureEquilibrium Pain Management Coaching & Massage Therapy

Overloading the young spine

Tomorrow marks the start of the last school term, so it's timely to think about backpacks and back pain in children.

A 2012 Spanish study looked at whether backpack weight is associated with back pain and back pathology in 1403 school children aged 12-17. It found that 61.4% had backpacks exceeding 10% of their body weight and those carrying the heaviest backpacks had a 50% higher risk of back pain. Girls had a higher risk of back pain than boys. The study concluded that carrying backpacks increases the risk of back pain and possibly the risk of back pathology.

Poor fitting, overloaded and incorrectly worn backpacks can place stress on the back, shoulders and neck, contribute to poor posture and affect gait. The weight of a heavy backpack can pull a child backward and affect their balance. To compensate for this, the child may bend forward at the hips or arch their back. This can cause the spine to compress unnaturally and it can also affect the curvature of the lumbar spine, causing it to become more shallow and changing the angle of the sacrum. Backpacks with narrow, unpadded straps can cut in to their flesh, reducing circulation and compressing nerves. This can cause tingling, numbness and weakness in their arms and hands. Children who experience back pain are at an increased risk of having back pain as adults.

Some good tips for choosing and wearing backpacks include:

  • The weight of the full backpack should weigh no more than 10% of your child's body weight.

  • The backpack should never be wider or longer than your child's torso and never hanging more than 4 inches below the waist.

  • Choose a backpack with padded back and shoulder straps to avoid cutting into their flesh and with hip and chest belts that help transfer some of the weight to the hips and torso.

  • Backpacks with multiple compartments are better for distributing the weight.

  • Compression straps on the sides or bottom help to stabilise the contents.

  • Make sure your child carries the backpack with both shoulder straps over the shoulders, not hanging over one shoulder as this causes them to shift their weight to one side (compensation).

  • Only take what is required, don't be tempted to fill the backpack to capacity because their is space. If its not needed, leave it at home.

  • Pick up their backpack from time to time, to check that weight.

This graphic from the American Chiropractic Association gives some good visuals and tips.


Department of Education and Training. (2016). Health, safety and wellbeing: Backpack Safety [Factsheet]. Australia: Queensland Government.

National Safety Council. (n.d.) Backpack Safety: It's Time to Lighten the Load. Retrieved from:

Nemours Foundation. (n.d.) Backpack Safety. Retrieved from:

Rodríguez-Oviedo, P., Ruano-Ravina, A., Pérez-Ríos, M., García, F. B., Gómez-Fernández, D., Fernández-Alonso, A., ... & Turiso, J. (2012). School children's backpacks, back pain and back pathologies. Archives of disease in childhood, 97(8), 730-732.

Walicka-Cupryś, K., Skalska-Izdebska, R., Rachwał, M., & Truszczyńska, A. (2015). Influence of the Weight of a School Backpack on Spinal Curvature in the Sagittal Plane of Seven-Year-Old Children. BioMed research international, 2015.


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