Can Heavy School Bag Cause Back Pain in Children?

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Growing concerns of parents highlight that the most important cause of back pain in children is heavy school bags. Heavy handbags and backpacks have known to cause backaches in adults, too. Since, the children's backbone is disturbed by the weight of their school bags during their growing years the pain may result in a poorly shaped spine, if ignored.

Medical conditions that can cause back pain in children include injuries to bones and joints, sciatica, spondylosis (congenital structural defect in the backbones) and Scheuermann's disease (a growth disorder of backbones, resulting in a humpback curvature).

While children complain of shoulder and back pain due to heavy school bags, parents, teachers and doctors have raised a doubt if the backache is due to other reasons such as sedentary lifestyle or poor posture.

There has been an increase in the number of studies worldwide attempting to find if carrying heavy school bags can cause backache in children. The results of these studies indicated that the burden on the children is not just in terms of competing in academics and extra-curricular activities, but also on their developing backbones.

Many children all over the world suffer back pain due to carrying heavy school bags. However, an understanding of the possible risk factors of school bags can help in overcoming the problem to some extent. The risk factors for back pain due to heavy school bags include:

• Weight of the school bag more than 10 percent of the child's weight
• Carrying the bag over one shoulder
• Weight and things distributed unevenly in the bag
• Holding the bag in one hand by straps
• Wrong fitting and shape of backpack.

There are many studies that indicate that the effects of heavy school bags are not only harming the back and spine, but also other parts of the body. This is due to uneven distribution of the weight of the bag. Some of them are listed below:

• Study published in June 2004 is based on the question whether backpack is linked to spinal disease. Analysis of several papers indicates that weight of the school backpack in children significantly increases the chances of backache, especially when the weight of the bag exceeds 20% of the body weight of the child. Their findings include:
• Time spent in carrying the bag and the weight of the bag affected the back pain.

• Heavy school bags have been the culprits to cause various problems like injury to hands, elbow, wrist, foot and ankle, apart from back and shoulder.
• Posture and gait were found to be affected in children carrying bag with two shoulder straps.
• Posture of spine changes with increased weight of bag.
• Study published in January 2014 was done to gather evidence about the physical problems faced by children due to heavy school bags, in Uttar Pradesh, India. Children of 10-13 years were selected and study revealed that physical stress was severe in children aged 12-13 years, but children aged 10-11 years faced maximum stress. Most of the children reported back pain, shoulder pain, muscle spasm and sometimes even red marks on shoulder.
• Study published in The Daily Telegraph, in 2012 observed that over half of the 1400 school children studied had backpacks exceeding 10% of their body weight. Those carrying the heaviest bags had 50% increased risk of back pain than the children carrying lightest bags. Results of other similar surveys done in UK, reported in The Daily Telegraph, found that nearly half of all teenagers have had occasional backache from poor posture, leading a sedentary lifestyle and also carrying overloaded bags.
• Study published in 2011, was conducted among a sample of 307 elementary school children in Iran. The children carried more than 10 % of their body weight, specially girls and lower grade kids. Pain was reported in shoulder (70%), wrists and hands (18.5%) and lower back (8.7%).
• In a study done in Italy, in 2002, the school bags of 237 children of grade 6 were weighed for six school days. Fatigue was reported by 65.7% of the children and 46.1% of the kids complained of back pain due to school bags. It was found that carrying bag during fatigue and time carrying it are associated with the back pain.

• Study published in December 2012, in India, had a diagnostic criteria to find out the prevalence of different musculoskeletal problems among school children. The criteria included pressure marks over neck and shoulder corresponding to straps of the bag, stooping posture while carrying the bag, pain or stiffness in the neck, upper back and shoulders during school days and also absence of these symptoms during vacations. Pain was most prevalent in the upper back (40%), followed by neck (27%) and shoulder (20%). Pain in forearm and wrist were reported in 7% and that in lower back was in 6% of the children.

The above studies indicate that heavy school bags can cause backache in children. The growing bones and muscles of the children are affected by the weight of the bag and also the duration they carry the weight. Other studies have also indicated that parental supervision is the most important measure to be taken to reduce the burden on the young shoulders and backs.

Some Tips to Reduce Weight in School Bags

Developed countries offer student locker facilities to help all students store their study material such as text books, note books and similar educational aids, thereby reducing the load from the bags they carry to school every day.

In developing countries the solution lies in a multi-dimensional approach. At the larger level, the government's educational department should begin by reworking school syllabus to reduce the load of books that children are required to carry every day to school and back

Home-school co-operation is also of vital importance to tackle this strain on children. Government schools and private schools may consider choosing desks with drawers that can be locked, for the use of students.

Teachers can adopt a more positive approach such as giving clear instructions for the study material required for the next day and refrain from penalizing students for not bringing books and study materials.

Parents should foster in children the habit of packing school bags every day according to the day's time table, so students bring to school each day only those books and kits which are definitely required for the day.

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