The association between backpack weight and low back pain in children1

Objective: The weight of a child’s backpack is widely thought to contribute to back pain. No studies directly support numerous general guidelines on backpack use. This study is designed to investigate the relationship between back pain and backpack weight in an American school population. Study Design: Blinded, cross-sectional, observational study. One hundred and eighty four schoolchildren in the third grade and middle school levels filled out a questionnaire on individual habits and back pain. Height, weight, and backpack weight were measured by blinded observers. Results: While there was a relationship between age and back pain (45.6% of middle schoolers, vs. 15.3% of 3rd graders, p < 0.01), the relationship between back pack weight and back pain was not significant. Those who carried other objects (musical instruments, sports bags, etc.) had have increased back pain (p = 0.019), but this relationship disappeared with age adjustment. Conclusion: Contrary to media hype, laws, and position statements, this first study of the relationship between back pack weight and pain suggests that there is no independent relationship between back pack use and back pain in American school children.