Do Schoolbags Really Cause Back Pain in Children?
- Edward Walsh
- Mar 17
- 2 min read
Every year, as back-to-school season rolls around, the same concern pops up: are heavy backpacks harming children's spines? It feels like common sense that carrying a heavy load every day could lead to back pain.
Well, the research has been done extensively, and the results may surprise you.
The Myth of the Dangerous Backpack
For decades, parents, teachers, and even healthcare professionals have cautioned against overloaded schoolbags. The Pediatric Orthopaedic Society of North America recommend that children carry no more than 15% of their body weight in their backpacks. Some schools have even implemented policies reducing book loads or encouraging ergonomic backpacks.
But does the research actually support these concerns? No.
What the Research Says
A 2018 systematic review by Yamato et al., published in the British Journal of Sports Medicine, examined 69 studies involving over 72,000 children to determine whether schoolbags contribute to back pain. The review included five high-quality longitudinal studies, which provide stronger evidence than the many cross-sectional studies that exist on the topic.
Key Findings:
No consistent link was found between backpack weight and back pain.
Bag design, carrying method, and weight distribution also showed no clear association with pain.
Perception of weight was the only factor associated with pain—children who felt their bags were heavy were more likely to report discomfort, regardless of actual weight.
Pain is a Perception
This highlights a fascinating reality: our perception shapes our pain experience. If a child believes their backpack is too heavy, their brain may amplify pain signals, making them feel discomfort—even when the load is within a reasonable range.
When adults unduly worry about a child's backpack, that reinforces the message to the child that the backpack is heavy and that it is something to be concerned about. Without meaning to, the adult may contribute to the child's pain.
Helpful Focus
Instead of worrying about the perfect backpack, we should prioritise:
🏫 Pain Education: Teaching children and parents about how pain works can help reduce fear and misconceptions.
🏃♀️➡️ Encouraging Movement: Regular physical activity, rather than worrying about backpack weight, is more beneficial for spine health.
😴 Sleep: Getting enough sleep is crucial for children and teenagers as they grow. Learn more about the relationship between pain and sleep here 👇
The Takeaway
Schoolbags are an easy scapegoat for back pain in children, but the evidence just doesn’t back it up. It’s time to shift our focus away from backpacks as a back pain driver in children. Failing to do so may actually cause children pain.
References
[1] OrthoKids - Backpack Safety - Accessed 17.03.25
[2] Yamato, T. P., Maher, C. G., Traeger, A. C., Wiliams, C. M., & Kamper, S. J. (2018). Do schoolbags cause back pain in children and adolescents? A systematic review. British journal of sports medicine, 52(19), 1241–1245. https://doi.org/10.1136/bjsports-2017-098927
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