Packing Pain: Study Reveals New Insights About Backpack Pain

How to prevent backpack-related injury now.

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This research study revealed two notable findings: Teen girls appear to experience more severe backpack-related pain compared to boys, and the time carrying the backpack—not the weight—is likely causing that pain. However, whether you’re a student or a commuter who uses a backpack to tote your laptop to and from work, it’s important to understand how backpacks can contribute to back pain now and down the line. While this Italian research may help medical professionals develop effective preventive measures in the future, you can prevent backpack-related pain today with some simple tips. But first, a closer look at the study.
Young girl wearing a heavy backpack.It’s important to understand how backpacks can contribute to pain now and down the line. Photo Source:

Research Goals of the Italian Backpack Study

The study, published in the June 2016 issue of The Spine Journal, covered 5,318 Italian students aged 6 to 19 years. The researchers broke the student sample into three age groups: children, younger adolescents, and older adolescents.

The goal of the study was to understand the students’ backpack pain related to (1) how common and severe it is, (2) differences between males and females, and (3) predisposing factors.

Through a series of interviews, researchers discovered that more than 60 percent of the students had backpack-related pain. Researchers noticed a significant spike in pain reports in young and older adolescents compared to younger children, despite younger children carrying more weight in their backpacks. The researchers found how long a bag was carried had more of an impact on pain, which contradicted many long-held beliefs that the weight of the backpack was the primary driver of pain. The key takeaway here is if you don’t need to carry your backpack, put it down. Wear it only when you’re traveling from one location to another. Mindlessly wearing your backpack could end up causing you pain.

The study also found girls had more frequent and intense pain compared with boys, and adolescent girls were found to be at greatest risk of experiencing severe pain. The researchers attribute this to a variety of factors, including female body structure, that warrant further exploration to determine why adolescent females perceive more severe back pain compared to their male counterparts.

Can Backpacks Really Cause Long-Term Problems?

More than 14,000 children are treated for backpack-related injuries each year, according to the U.S. Consumer Product Safety Commission. Can these childhood injuries result in long-term back problems or chronic pain?

The answer, according to Scott Bautch, DC, DACBOH, CCST, CCSP, is yes.

“By the age of 14, 7 percent of children report that back pain affects their everyday life,” Dr. Bautch says. “The lumbar (lower) spine is vulnerable to injury when children carry heavy loads. Such injuries may also lead to early degenerative changes in the lower spine.”

But it’s not just the weight you carry in your backpack, but how you carry it, Dr. Bautch says.

“Studies have also shown that carrying loads unequally, such as when a child carries a backpack on one shoulder, can cause the more frequently loaded shoulder to be lower and may cause lateral spinal curves,” Dr. Bautch says.

blue backpack with school supplies“A major error is buying a backpack that is too large, which encourages overloading”

What You Can Do Today to Prevent Back Pain Tomorrow

It’s never too early to start developing good backpack habits, and Dr. Bautch recommends practicing good backpack techniques by age eight. These habits include correctly fitting the backpack, properly loading the backpack, and choosing what needs to be in the backpack.

Not all backpacks are created equal. You don’t need to buy the most expensive backpack on the market to prevent injury, but you should look for backpacks with the features below:

  • DO look for a backpack with wide, padded straps
  • DO opt for backpacks with hip and chest belts, as they improve balance and take strain off sensitive neck and shoulder muscles.
  • DO seek out backpacks with multiple compartments to better distribute weight.
  • DO consider a backpack on wheels if you travel long distances or carry a heavy load.

And, below are some things to avoid when purchasing or wearing a backpack:

  • DON’T think bigger is better. “A major error is buying a backpack that is too large, which encourages overloading,” Dr. Bautch said.
  • DON’T wear only one strap of the backpack. This shifts weight to one side.
  • DON’T let your backpack hang more than four inches below your waistline. This reduces pressure on your shoulders and protects posture.
  • DON’T let your backpack weigh more than 10 percent of your body weight when it is full. Heavier backpacks cause you to bend forward to support the weight, straining your back and neck.

For many parents, the struggle often comes from kids wanting a specific backpack because it features a particular super hero or cartoon character, but that might not be the healthiest choice. Dr. Bautch recommends using positive language that helps your child understand why the best-designed and best-fitted backpack is the best option in the long run—and make sure they are involved in the purchasing decision.

And for students and others who regularly tote backpacks, Dr. Bautch’s advice is simple:

“You get one body for a lifetime,” he says. “Good postural habits, good exercise habits and good eating habits greatly improve your chances of living a healthy and fun life. When it comes to taking care of yourself, you can never start too early.”

Updated on: 08/12/19
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Scott Bautch, DC, DACBOH, CCST, CCSP
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