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Backpacks & Back Pain in Children

Updated: Aug 13, 2019

adapted from maxliving.com

School Shopping for Backpacks


An upcoming school year means pens, pencils, notebooks, and other essentials that fit into a new backpack. While manufacturers often focus on style, sizes, and what you can carry, good backpacks should also be designed for optimal back support.


Tablets or other e-devices replacing heavy books at many schools means less stuff to carry. Still, your child or teen might overstuff their pack and create back problems, especially on their lower back.


Researchers define lower back pain (sometimes called lumbar back pain) as pain in the backfrom the level of the lowest rib down to the gluteal fold. That pain may or may not travel to the legs.

Researchers estimate chronic lower back pain has increased over 100 percent among adults during the last decade. Physical concerns aside, the increasing burden of lower back pain creates a massive financial strain, costing Americans over $90 billion a year.

Lower back pain is also a common complaint among children and teens. Researchers estimate that while about 30 in 100 children and adolescents experience back pain, very few go to see their doctor.


Lower back pain often begins in childhood and increases with age. By age 15, 20–70 percentof children will report some back pain. This pain can recur, often more intensely. Overall, back pain occurs in 60–80 percent of people during their lifetime. Children with lower back pain are more likely to have back pain during adulthood.


Childhood chiropractic care for the prevention of spinal degenerative disc disease often referred to as “arthritis” and to avoid back surgery. Further studies on the Epidemiology of Degenerative Lumbar Disk Disease in Children may be read here.



What Causes Lower Back Pain in Children?


Low in the back, the lumbar vertebrae — five vertebrae linked by joint capsules, ligaments, tendons, and muscles, with extensive innervation — are the last free-moving vertebrae in the spine, while the sacral and coccygeal sections are fused and extend into the buttocks.

The buttocks, groin, thighs, and legs are anchored here, and the nerves that move through the lumbar spine affect lower intestines and reproductive organs.


Lower back pain, the most common type of back pain, is not a disease but a symptom with many causes. Doctors can usually diagnose underlying causes from the type and symptom of back pain.

Nighttime back pain usually comes with fever and weight loss that could indicate a tumor or infection. Acute back pain, chronic back pain, and back pain associated with fever could likewise come with associated symptoms that suggest possible diagnoses.


Among the most common causes of lower back pain, which can occur separately or together, include:



Back pain can also impact other muscles, including tight hamstring muscles and weak abdominal muscles, especially among adolescents.


While you might be tempted to blame the lower back pain on a heavy backpack or poor posture, lower back pain oftentimes doesn’t have a single culprit. In fact, one study could not find a specific cause for back pain in 78 out of 100 children.


Instead, many things children do every day can contribute to lower back pain. Spending a long time watching television and over-engaging in sports can create or exacerbate back pain. The increased roundness of the back that can occur sitting slouched is a common cause of pain in the middle or thoracic spine rather than lower back.


But obesity, familial history, and being sedentary are also possible risk factors for low back pain among children. Many things your child or teen does nearly every day — including carrying a backpack — can compound that lower back pain.


In most children and adolescents, the symptoms of back pain are transient and get better without treatment. Research shows that about half of all teenagers with back pain get better on its own.


While lower back pain is often not a serious condition, sometimes it can signify underlying causes such as:

  • A slipped disc

  • Vertebral fractures

  • Spinal alignment problems

  • Disc herniation (pressure on the nerves or spinal cord can occur with adolescents who do weight lifting)

  • Spondylolysis (spinal wear and tear, which sometimes occurs in athletic teens)

  • Spondylolisthesis (slippage of a vertebra frontwards or backward)

  • Infection (a leading cause of back pain in children under 10)

  • Very rarely, a tumor


Note: Please don’t diagnose your child or adolescent or allow them to self-diagnose persistent back pain, which could underlie a more serious cause. Visit your healthcare practitioner. No one should have to live in pain.


Symptoms of Back Pain (and When to See a Doctor)


Symptoms of lower back pain vary dramatically. Among them include:


  • Acute or chronic lower back pain (sometimes both).

  • Mild or severe lower back pain. (Again, severity can fluctuate.)

  • Lower back pain that travels to other areas such as the arms or legs.

  • Lower back pain that impacts sleep, school performance, mood, movement, and physical activity.

  • Lower back pain that sometimes gets worse or better depending on activity. Other times, pain levels change for no obvious reason.Lower back pain that involves other symptoms like high temperature (fever), weakness, numbness, tingling, and bowel or urinary issues.


While experts say back pain is common and some symptoms are often not a huge medical concern, under these conditions you should see your doctor:


  • If they are under four years old.If their back pain goes on for more than four weeks.

  • If their back pain stops them from doing things.If they feel unwell, have a high temperature (fever), or experience weight loss.

  • If the pain gets worse.

  • If they have pins and needles, numbness, or weakness.

  • If they start developing curvature of the spine.

  • If they start complaining of stiffness or difficulty when they move.


If your child sees a doctor for back problems, they will conduct a physical examination along with a history of back pain. To understand more how the problem developed, they will likely inquire about certain conditions.


Writing down the following information ahead of time can be helpful for your visit:


  • Your child’s overall health

  • An explanation about how the pain impacts daily life

  • When the pain began, whether it was associated with injury or demanding activity, and whether it has improved or worsened

  • The specific area where pain occurs

  • What makes the pain worse and better

  • Where the pain is felt, how severe it is, and how much it interferes with school and activities


Your doctor will probably examine your child’s spine, nerves in the back, leg, and back muscles, as well as balance, flexibility, coordination, and muscle strength.


Doctors can usually treat back pain without radiographic or laboratory studies for most children and adolescents without significant physical findings, short duration of pain, and a history of minor injury.


Patients with more concerning physical findings or history might require further treatment for the affected area.


Diagnosing tools for low back pain include X-rays, bone scan, computed tomography (CT) scans, magnetic resonance imaging (MRI), and positron emission tomography (PET).


Especially if they suspect inflammation or infection as a factor in lower back pain, your doctor might also conduct blood tests including a complete blood cell count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).


Acute strains typically resolve after rest and modifying activity. To speed the process, doctors might also recommend ice to relieve swelling and pain. A warm compress might subsequently help relax muscles and decrease muscle spasm.  


While persistent pain might warrant a doctor visit, back pain doesn’t often require emergency t