Chiropractic: Carrying Backpacks Versus Pulling Them on Trolleys

Bags really are a common site in the present schools. Nearly every child appears to bring a bag of one type or another. And there is sufficient proof to link backpack misuse and overloading will lead to back and neck pain. More students are reporting pain and discomfort associated with their back packs. Recent studies have reported that as much as 64% of children suffer with back pain (Negrini, 1999). These numbers are alarming, but that number doesn’t really matter. What matters is when your son or daughter is one of these. So what are parents to do?

Studies from John Hopkins Children Hospital and numerous other childrenes institutions show that back packs are a primary cause of neck, back, and shoulder pain and are also responsible for poor posture in children. The common student reports a visible analog pain scale amount of 4.3 with some attaining an 8-9, as explained by Northeastern College in June of 2001. The American Academy of Orthopedics found 71% of wellness practitioners feel backpacks are a health-related problem, 58% of these doctors see kids with pain connected to backpacks, and 52% genuinely think this could be a significant problem. In these studies, 55% of pupils carried an overloaded back pack, as explained by Simmons University in February of 2001. The Consumer Product Safety Commission reported 3,300 cases of children between the ages of 5-14 were seen in the emergency rooms in 1997 for back pack related injuries. An Auburn University study verified that 67% of children experienced muscle tenderness, 51% back pain, 24% numbness and 15% neck pain associated with backpacks. 65% of teenagers’ doctor visits are due to backpack accidents and this was reported on National Public Radio in October of 1998.

Reports from John Hopkins Children Center and a number of other childrens’ institutions show that back packs lead to neck, back, and shoulder pain as well as bad posture in children. The typical student reports a visual analog pain scale level of 4.3 with some achieving an 8-9, as described by Northeastern University in June of 2001. The American Academy of Orthopedics found 71% of health practitioners feel backpacks are a medical problem, 58% of these physicians see children with pain linked to backpacks, and 52% genuinely believe that this can be a serious problem. An overloaded backpack is carried by 55% of students, as described by Simmons College in February of 2001. The Consumer Product Safety Commission reported 3,300 of school aged children 5-14 were treated in emergency rooms in 1997 for backpack associated injuries. An Auburn University study confirmed that 67% of children experienced muscle tenderness, 51% back pain, 24% numbness and 15% neck pain. 65% of teenagers’ physician visits are due to backpack accidents as reported by National Public Radio in October of 1998.

Here are a few methods to find a suitable backpack and the proper way to make use of it. The acceptable load in a backpack is related to the child’s weight. Do not overload. One of the main 55% of pupils for injuries due to back packs is over loading. and according to  American Chiropractic Association as well as the American Academy of Orthopedic Surgeons, the following weight limits are recommended.

• A 60 lbs. child can carry a maximum backpack weight of 5 lbs.
• 60-75 lbs. can carry 10 lbs.
• 100 lbs. can carry 15 lbs.
• 125 lbs. can carry 18 lbs.
• 150 lbs. can carry 20 lbs.
• 200 lbs. can carry 25 lbs.
• Under no circumstances should a backpack weigh over 25 pounds, Carry only what is needed.
• To transfer the weight to the hips pack heavier items on the bottom.
• Use all of the compartments. Backpacks with multiple compartments help keep the load stable and keeps it from shifting.
• Flat items should be kept closer to the back and bulky or pointy items should be packed away from the back..
•  Always use both shoulder straps. Never carry a back pack on one shoulder.
• Make sure the shoulder straps are tight and the backpack sits no more no more that 4 inche below the waist line (where the belly button is, not the hips) and just below the shoulders.
• Use the waist and chest straps.
• Only carry the backpack when necessary.

Other Options

• Use handouts instead of textbooks or keep a second set of textbooks at home.
• If possible use separate backpacks for separate classes or activities and don’t carry all of your after school gear to every class.
• Use a different style of bag such as a saddle bag design that goes over the head with a bag on both the front and back is a good option.
• Do not use a shoulder bag because it is all the weight with only half the support.
• Do not use rolling bags. In a recent study using German primary school children. Researchers wanted to learn if giving the kids rolling luggage, to transport their school books,would reduce spinal pressure. The finding were that just because this works work well for Mom at the airport doesn’t mean that it works well for children. Hauling books across irregular sidewalks, and all the way to school can be a problem. This shows that school children should use bags in the place of trolleys but load the backpacks to the appropriate weight.

It’s well understood that heavy backpacks are taking a heavy toll on our childrens spines. The Department of Orthopedic Surgery, University of California,  recently conducted a weight barring (standing) magnetic resonance imaging study and found “Increasing backpack loads significantly compressed lumbar disc heights measured in the midline sagittal plane” and that: “student subjects reported significant increases in back pain, associated with increasing backpack loads from 4, to 8, and finally to 12 kgs of carried weight”.

In a recent study using German primary school children. Researchers wanted to learn if giving the kids rolling luggage, to transport their school books, would reduce spinal pressure. The finding were that just because this works work well for Mom at the airport doesn’t mean that it works well for children. Hauling books across irregular sidewalks, and all the way to school can be a problem. This shows that school children should use bags in the place of trolleys but load the backpacks to the appropriate weight.

It is important that parents and children follow the safety tips for backpack use. This will help children avoid back injuries early in life and produce a better quality of life in their twenties, thirties, and forties.

Reference: Negrini S, Carabalona R and Sibilla P (1999). Back pain as a daily load for school children. The Lancet 354: 1974.

By: Paul R. Mahler Dc Jr.