Back-to-School, Backpacks, and Back Pain in Children


I’m seeing it on every street corner; It’s time for students to return “back-to-school” and here they are, loaded up with their new backpacks filled with books, electronics, and after school sports gear. Some children have them on their backs, others have them slung over one shoulder, while others have them on wheels and are pulling them in tow. Most children are leaning forward, or twisted sideways, to counter the weight of their heavy load.

Many schools are eliminating lockers citing safety issues, and many children go to school in the morning, stay in after school programs until late afternoon or early evening. Both situations increase the amount of things a student needs to bring to school and explains why children’s backpacks are of considerable size. Hikers in the Himalayas have been known to hire Sherpas to carry less gear than what most children haul around each day. It’s no wonder that there is a growing incidence of lower back pain in children and especially in teenagers.

Backpacks are not the only contributor to childhood back pain. Poor posture is another factor that exacerbates the issue. Many students are hunched over computers or tablets for hours a day, much like their adult counterparts. Sadly, “good posture” is not taught in schools to the extent that it used to be. Good posture has many physical benefits. It allows you to breathe better, improves your circulation, maintains a healthy spine, and benefits your muscles and joints. Better circulation also contributes to a positive frame of mind which translates into greater receptivity for learning.

A chiropractor friend of mine recently forwarded a newsletter (from Lauterbach Chiropractic) which states: “Back pain is a common complaint in teenagers, and 94% of teens with low-back pain say their symptoms limit their daily activities. Having back pain in adolescence also increases your risk of suffering from chronic symptoms as an adult, making it all the more important to seek early treatment.”

Typically, I see teenage patients to treat acne, sports injuries, or to help them manage stress and improve concentration. And now, I’m beginning to see younger patients for back pain. Fortunateley acupuncture is a fast, safe and effective treatment for back pain. If your child complains of shoulder, neck and back pain, please consider making adjustments to the size and weight that they must carry around with them. The American Academy of Orthopedic Surgeons (AAOS) recommends limiting backpack weight within 10-15% of a child’s body weight. The American Chiropractic Association (ACA) recommends not more than 10% of a child’s body weight.

Here are some tips from the ACA to help parents select the best backpacks for their students:

  • Is the backpack the correct size for your child? The backpack should never be wider or longer than your child’s torso, and the pack should not hang more than 4 inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.
  • Does the backpack have two wide, padded shoulder straps? Non-padded straps are not only uncomfortable, but also they can place unnecessary pressure on the neck and shoulder muscles.
  • Does your child use both straps? Lugging a heavy backpack by one strap can cause a disproportionate shift of weight to one side, leading to neck and muscle spasms, low-back pain, and poor posture.
  • Are the shoulder straps adjustable? The shoulder straps should be adjustable so the backpack can be fitted to your child’s body. The backpack should be evenly centered in the middle of your child’s back.
  • Does the backpack have a padded back? A padded back not only provides increased comfort, but also protects your child from being poked by sharp edges on school supplies (pencils, rulers, notebooks, etc.) inside the pack.
  • Does the pack have several compartments? A backpack with individualized compartments helps position the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child’s back, and try to place the heaviest items closet to the body.

Then, of course, you might want to try the “My Fair Lady” solution to heavy backpacks and poor posture: have your student carry a book or two on their head! All joking aside, if you are concerned about the weight your child must carry, consider some practical alternatives. If back pain doesn’t subside with adjustments to weight and method of carrying a backpack, do see your pediatrician to see if something more serious is not the cause. Also, consider acupuncture to treat any neck, shoulder and back pain. I’m offering a “Fall Tune-up” Special to help families get off to a good start for the active season ahead. After all, going “back-to-school” should not be a pain-in-the-neck!

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The Healing Point Acupuncture Clinic
Xia Xin, L.Ac., CSMA


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