Back Pain in Students
The Relationship Between Back Pain and Back Packs
Just in time for homework and fall days, I had a conversation with Channing Tassone, MD, an Assistant Professor of Pediatric Orthopaedics at the Medical College of WI!
Is there any validity to the concerns regarding children between the ages of 4 to 12 for the using of backpacks?
The current literature does in fact show that there can be an increase in back pain and changes in posture and gait. There is also a slightly more esoteric concept that while a backpack was present there was actually a change as a negative in the pulmonary function of the children who were wearing the back packs.
This in not necessarily age specific to the 4 to 12 year olds; all the studies that I had available to me were generalized to the school age children. So, the issue mostly comes to pain and change in posture while the back pack is on.
To say the incidence of back pack related pain has increased over the past decade I could not find anywhere in the literature but certainly you and I have the same impression that kids that we interact with at this point state that their back packs are getting heavier and heavier due to more and more books and that will weigh them down more but I could not find data to support that although I do agree with that.
What is your recommendation of the appropriate use of backpacks?
There are a handful of things that should be done:
- The backpack should be - some recommended as low as 10% of the child's weight and some recommended as much as 15-20% of the child's weight.
- In addition, there were a couple of studies looking at the biomechanics of backpacks that you have an abdominal strap to hold it to the child and they found that their posture was better with those.
- Children with access to lockers reported to have less back pain.
- Interestingly, it has been found that using one versus 2 straps does not have a significant difference in association with pain
Of the children demonstrating signs of pain, about 30% of them had to limit their activities through their pain, 15% using medicine for the pain and 80% felt that the backpack caused or worsened their pain.
Is it ever safe to use backpacks?
Certainly, keeping in mind the provisions previously described, including correlation of weight and the age or developmental stage of the child. I think that is the nice thing about the percentage of body weight is that then you can basically figure that through all ages; the smaller children would carry a lighter pack than the older children.
Can continuous use of a backpack cause injury to any other part of the body?
No. Parents need to simply talk to their children about back pain and if an injury is suspected children need to inform their parents. Again, for children who have back pain, going to their primary care physician is very reasonable.
Many childrendo end up in orthopedics but they certainly wouldn't need to (go)directly. All I do from an orthopedist perspective with children that present with back pain such as this is send them to physical therapy and have them do conservative measures with trunk strengthening and stretching; 99% of the time this will make their pain resolve.
If their pain be directly related to something specific,like a backpack, than they may benefit from modifying backpack usage.
How can injuries be prevented?
The things previously described. The other thing I do is when I do spinal surgeries I write a note for the child so they can have 2 sets of books so that these children are not obligated to carry the books anywhere and that decreases the load for them.
The rolling backpacks are great,although I recently had a discussion with one of my patients in clinic who I was seeing for another reason and we got on the subject of backpacks. I asked what the social acceptation of rolling backpacks is. She said she absolutely would have nothing to do with a rolling backpack. I don't know if this was with her school only but that didn't help me because I thought this may be a solution - but if it is not socially accepted by others the children probably will not use them.
Could the backpack have anything to do with the actual creation of a spinal deformity?
The literature absolutely disputes that. There is no correlation with backpacks and spinal curvatures. The only correlation is between backpacks and pain.
Many thanks to Dr.Tassone, of the Medical College of Wisconsin for his time, patience and expertise for todays column!
Other Resources on the Suite:
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Want Less ck in? Stop Being Afraid of It
Low ck in and the Psoas Connection
