Chiropractors, pediatricians and orthopedic surgeons alike agree that backpacks are a problem for a child’s spine. While a backpack alone may not cause major problems, overloading and improper carrying of a backpack can lead to headaches, neck, shoulder, and lower back pain.

According to an article published in Spine, “Of the 1,122 backpack users, 74% were classified as having back pain, validated by significantly poorer general health, more limited physical function, and more bodily pain.”

So how heavy is too heavy?

While health care professionals do not agree on the exact weight, the consensus is that a child burdened with more than 10 percent of his or her body weight risks back and neck pain; and the majority of health care professionals agree that a child carrying more than 15 percent or more of his or her body weight can suffer from severe back, neck and shoulder pain, headaches and other spinal discomfort; not to mention aggravate preexisting spinal conditions such as scoliosis.

But how can I lighten the load I hear you say?

It’s important to have parents weigh their child’s backpack at least once a week. If it exceeds the “15 percent” rule of their child’s weight, the parents should be encouraged to work with their child to evaluate his or her backpack and determine how to “lighten the load.” A backpack stuffed with that “extra” book, binder, electronic device or water bottle can easily add up to an unnecessary 5 kg.

We should also be showing our children the importance of loading and carrying their backpacks correctly. The heaviest items should always rest against the back, which means loading them first and attempting to distribute the weight evenly. Another thing to consider is while the child may think nothing of carrying his or her backpack slung over one shoulder, the truth is that this fashion statement is damaging to the developing spine. When carrying a pack on one side only, one shoulder is required to carry a burden that both shoulders and the back should be sharing equally. The only proper way to carry a backpack is with both straps over the shoulders and the backpack resting against the lower back.

The first priority in purchasing a backpack is to select function over fashion. This request may be easier said than done. Parents should consider the following criteria when choosing a better functional backpack: first that the backpack fit properly (not too long or too short); and second, that it has wide, padded, adjustable straps (for proper positioning on the back). A third option is to look for a backpack with a hip strap or lumbar pillow. The hip strap, when used, can distribute a portion of the weight to the hips, easing the load on the spine and shoulders. The use of a lumbar pillow will provide the necessary back support to the lumbar region, where the greatest portion of weight is being carried. When shopping, parents should consider that the more support features on the backpack they buy, the less spinal stress their child will carry.

So, as your children are preparing to return to school, take a brief moment and educate the entire family about “function over fashion.”

Dr Bajcic’s Top 5 Recommendations for Parents

5. Every Sunday empty out your child’s backpack and review what they have stuffed inside. You would be surprised what items accumulate inside that adds unnecessary weight. If this is a teenager, find out if they need to carry all their books all the time, or is their schedule Monday, Wednesday and Friday different from Tuesday and Thursday?

4. Check the backpack straps for proper shoulder placement, making sure that the bottom of the backpack is two inches above the waist and resting in the curve of the lower back.

3. Continue weekly reminders that wearing the backpack on both shoulders prevents postural problems.

2. Weigh your child’s backpack once a week to determine if it is within the safe range of 15% or less of your child’s body weight.

1. If your child is not under regular wellness chiropractic care, check your child’s shoulder and head level at least once a month to determine if they are showing early signs of repetitive stress on their growing spine. A Family Wellness Chiropractor who is trained to detect the early signs can perform this exam. Like dentistry, early detection and correction is key to better health.

For a great recommendation for a backpack that has been approved by the Chiropractic Association of Australia speak to your family chiropractor.


1. American Academy of Orthopedic Surgeons Bulletin, December 1999; 47(6).

2. Sheir-Neiss GI, Kruse RW, Rahman T, et al. The association of backpack use and back pain in adolescents. Spine, May 1, 2003; 28(9):922-930.

3. Arnsodorff M. Mounting research on backpack use. ICPA Newsletter, May/June 2002

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