How to Prevent Back Pain from Backpacks
By Emily Dodwell, M.D., MPH, FRCSC

How to Prevent Back Pain from Backpacks

August 6, 2015   |   ASK THE EXPERTS  

Come September, your children will be schlepping books, homework, and lunch boxes to and from school five days a week. Dr. Emily Dodwell, a pediatric orthopedic surgeon, shares tips for choosing the best backpack and how to prevent back injuries with tips for packing and carrying a backpack.


Although some of the best weeks of summer may be yet to come, it is not too early to start thinking about preparing for the upcoming school year.

Choosing the right backpack is important; children may need to carry textbooks and notebooks, a change of clothes and shoes, lunch and snacks, and more. This can add up to some serious weight, and often children are not just carrying these items to school, they’re carrying them from class to class and up and down stairs all day.

Many schools in Manhattan and surrounding areas have unique features that may add some extra challenges when deciding on the right backpack for your child. Schools are often in older buildings with a taller structure and multiple flights of stairs between classes. Some schools do not have space to provide individual lockers to children, so children have to carry with them everything they need throughout the day. 

Although there is no evidence that backpacks that are too heavy or worn asymmetrically can cause scoliosis (curvy spine), extremely heavy or improperly fitting backpacks may cause muscle strains, and back neck or shoulder pain. It is important to optimize the backpack, how it is worn, and how it is packed.

When considering a backpack for your child, look for:

  • Two shoulder straps (symmetric)
  • Wide padded straps (improved weight distribution and comfort)
  • Waist strap (can help better distribute the weight)
  • Light-weight material (weight adds up when the bag itself is too heavy)


When packing the backpack:

  • Aim for no more than 10-20 percent of your child’s weight
  • Put heavier items lower, more central and closer to the back


When wearing the backpack, advise your child to:

  • Bend from the knees when picking up the bag
  • Wear on both shoulders to distribute the weight
  • Tighten straps so the backpack is close to the back


There may be some other options to lighten the load:

  • Rolling backpacks are a bit like a rolling suitcase, and remove the weight from the back. However, they may not work well in a school with multiple sets of stairs, and some schools feel these are a tripping hazard, so check with your school if they have guidelines on bringing these to school.
  • Encourage your child to make multiple stops at his locker, if he has one, during the day to avoid carrying all of his books all day.
  • Consider getting two sets of textbooks, one to keep at home, one at school.
  • Some textbooks have electronic versions that may be suitable for home study, although most schools are not using electronic textbooks for in-class use.
  • Work with your teachers and school board to consider if there are other ways to reduce backpack weight.
  • On very heavy days some books could be removed from the backpack and carried.


If your child is having back, neck, or shoulder pain, or numbness or tingling, her backpack may be too heavy or she is wearing it incorrectly. However, there are many reasons for back pain other than a heavy backpack, such as pain from using muscles during sports, poor posture, or slouching in class or while studying. An initial approach to back pain is to remove the cause of the pain, whether it is lightening the backpack, taking a break from sports, or ensuring a more ergonomic position for studying. If your child has persistent back pain, your pediatrician or pediatric orthopedic surgeon should evaluate her.

In order to encourage a healthy back for life, consider making back health a part of the regular routine. Consider enrolling your child in an activity that he finds fun, and promotes stomach and back strength and posture, such as swimming, yoga or Pilates.