Unpacking Back Pain


Over the past several years a lot has been written about how backpacks are causing an increase in back pain among school-aged children. I have heard much well-meaning advice regarding this topic, and I often get asked to write letters to educators so that students can be excused from carrying heavy backpacks. If we dissect the evidence, can we truly blame backpacks as the culprits of back pain?

myths about back pain

Your child should carry no more than 10% of his or her body weight.

This percentage has no scientific basis; it was a number that was arbitrarily decided upon and many clinicians agreed that that was the number. However, there are no studies that have been conducted that give this number any credibility over another. When it comes to an actual weight, let your judgment be the rule. Some children are just stronger than others.

Heavy backpacks cause scoliosis and/or can advance a scoliotic condition.

This is nothing more than fear mongering. Not one study has ever shown this to be true. In fact, loading (strengthening) a scoliotic spine can actually make it stronger, and that is never a bad idea.

Backpacks cause disc herniations.

False! Years of repeated bending/ flexing at the waist or sitting for prolonged periods of time are the most common causes of disc herniation of insidious onset (occurring for no apparent reason). This has been well-documented for decades in a multitude of spine studies.

Backpacks promote poor posture.

Now let’s think about this one. If a student is carrying a heavy backpack for many hours throughout the day, then I could easily see the logic, but the truth is that most children carry their backpacks for very short distances. In fact, carrying a heavy back pack for short distances can be viewed as strength training that can actually help improve your child’s posture.

What’s really going on?

For the past 28 years I have interviewed and treated thousands of school-aged children with back pain. Upon close questioning and testing, never once have I found that the patients’ pain was the direct result of a heavy backpack. Back pain of insidious onset is caused by poor sitting posture, frequent bending/flexing at the waist, and/or an inability to extend (bend backward) your spine. So, the next time your child complains of back pain of insidious onset, consider checking their posture and ask them to extend their back.

See how to do it with our EXTENSION IN LYING/LUMBAR VIDEO. To view other  demonstrations, visit McAllen Physical Therapy YouTube page.

Fortino Gonzalez is a physical therapist, Diplomat in Mechanical Diagnosis and Therapy (Dip MDT), Fellow in the American Academy of Orthopedic Manual Physical Therapists (AAOMPT), and Board Certified Orthopedic Clinical Specialist (OCS) serving the Rio Grande Valley from his practice, McAllen Physical Therapy. To learn more, visit www.fortinogonzalezpt.com or call 956-661-1964.