Packing Up Back Pain

Today, many students carry backpacks so full of books, supplies and sports equipment that back pain is becoming more and more of a problem in young people. “If your child says he has back pain, don’t ignore the complaint,” says Dr. Tonia Cox, a pediatrician with Pediatric Diagnostic Associates. “Pain is a red flag and numbness or tingling is a big alarm.”
By Pamela Boaz
Backpack Troubles
As the popularity and size of backpacks have grown, some research indicates that the rate of back pain in children has grown, as well. The majority of the problems begin in middle school, when students begin to change classes throughout the day. While many schools have rules requiring backpacks to be stowed away in lockers during the school day, other schools do not have the same restrictions. In those cases, students carry all of their books with them throughout the day, creating stress on their backs. In high school, the size and weight of textbooks often increases and classes may be further apart, increasing the potential for back pain.
“The major problem created by carrying backpacks that are too heavy is back strain, which means it is a muscular issue,” explains Dr. Jay Jolley, an orthopedic spine surgeon with the Spine Group at the Center for Sports Medicine. The cause of the pain is too much weight over too long a period with improper weight distribution. Too much weight for too long can even interrupt circulation to nerves and cause tingling or numbness.
Guidelines suggest that the maximum weight for a backpack should be no more than 10 to 20 percent of a child’s body weight, depending on the student’s frame. That means if your child weighs 100 pounds, he or she should never carry a backpack weighing more than 10 to 20 pounds.
Even with less than the maximum weight in a backpack, the uneven distribution of that weight can cause pain when the backpack is carried on one shoulder, which moves weight away from the body’s center of gravity. The person then leans to one side in order to compensate, putting a strain on the muscles. Although standing or walking with the body at an angle may lead to back pain, no research indicates that it creates a curvature in the spine or scoliosis, according to Jolley.
Preventing Problems
“The best treatment is prevention,” says Jolley. Prevention starts with consideration of backpack design and includes limiting and distributing the weight of the content, as well as planning for periods of back rest during the day.
The best backpack design includes two shoulder straps and a waist belt. “Kids must use both shoulder straps in order to properly distribute weight,” advises Cox. “It is best if the straps are wide and have padding. Choosing a backpack with a padded back is also a good idea, as are waist straps, which help to keep the weight evenly distributed.”
Parents need to monitor the weight of student backpacks. Remember that 10 to 20 percent of a child’s body weight is a maximum load. Textbooks are heavy, and so alternative plans should be made to eliminate carrying more weight than necessary. For instance, if your child has a small frame, one option is to acquire a second set of books to be kept at home. Another choice is to purchase a backpack with roller wheels.
Students should also learn how to bend properly with a backpack on their back – at the knees and not the waist – and plan ahead for locker stops throughout the day.
Schools can help by requiring that backpacks be kept in lockers during the school day. In addition, bell schedules can be designed to allow students to go to lockers frequently. Teachers can play a positive role, as well, by simply reminding students to use both shoulder straps. Homework assignments that alternate among subjects or that do not require textbooks can be helpful in reducing the weight students place into their backpacks.
“As a spine specialist, I do take very seriously a young person with back pain,” says Jolley. “For one who is 5 to 14 years old, it is uncommon to have significant back pain without a significant problem.
“If a child comes to me about back pain and, through a workup it is determined there is no serious cause for the pain, I will talk to them about other things going on in his or her life that could cause the pain,” Jolley says. If the backpack is the culprit, then following the recommended guidelines of doctors should resolve the problem. In addition, symptoms can be alleviated by using heat and/or cold compresses and over-the-counter pain medications. However, if back pain persists, take your child to the doctor to be evaluated.
More Than Just a Heavy Load
Back pain can, of course, have more ominous causes that go beyond heavy backpacks and muscular issues. If your child exhibits any of the following symptoms, it is important to schedule an appointment with a physician:
• Pain that is worse at night and awakens the person from sleep.
• Pain that doesn’t respond to heat or ice or over-the-counter pain medications.
• Fever or chills associated with back pain, especially in children from 18 months to 6 years.
• Back pain along with numbness or tingling in the legs, particularly in adolescents from 12 to 18 years old.
• Back pain accompanied by extreme fatigue.
Part of preventing back strain and injury requires making good back care a habit. “Exercise is key,” says Jolley. “It helps in maintaining ideal body weight, and it strengthens the core muscles that stabilize the back.”
Additionally, it is important to learn and use proper bending techniques: holding the spine erect, bend at the hips and knees. Learning how to bend over safely will help avoid any injury and strain to the back.
Carrying heavy loads of school supplies can cause bigger problems for a child later on down the road. But if caught early enough, back pain associated with a heavy backpack can be reduced or eliminated.

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