You probably don't give much thought to your backpack. It gets used, it gets abused, and it gets shoved in the bottom of your locker or the corner of your room.

But can your backpack abuse you? The answer is yes. When a backpack isn't used properly, it can cause back problems or even injury.

Backpacks Are Best

Backpacks can't be beat for helping you to stay organized. Multiple compartments keep all your supplies and notes close at hand.

Backpacks are a better option than shoulder or messenger bags for carrying books and supplies. That's because the weight of the pack is evenly distributed across your body. The strongest muscles in the body — the back and the abdominal muscles — support the pack.

But backpacks that are overloaded or not used properly can make for some heavy health problems.

How Can Backpacks Cause Problems?

Your spine is made of 33 bones called vertebrae. Between the vertebrae are disks that act as natural shock absorbers. When you put a heavy weight on your shoulders in the wrong way, the weight's force can pull you backward. To compensate, you may bend forward at the hips or arch your back. This can cause your spine to compress unnaturally.

People who carry heavy backpacks sometimes lean forward. Over time this can cause the shoulders to become rounded and the upper back to become curved. Because of the heavy weight, there's a chance of developing shoulder, neck, and back pain.

If you wear your backpack over just one shoulder, or carry your books in a messenger bag, you may end up leaning to one side to offset the extra weight. You might develop lower and upper back pain and strain your shoulders and neck. Not using a backpack properly can lead to poor posture.

Is your backpack getting on your nerves? It might be. Tight, narrow straps that dig into your shoulders can pinch nerves and interfere with circulation, and you might develop tingling, numbness, and weakness in your arms and hands.

Carrying a heavy pack increases the risk of falling, particularly on stairs or other places where the backpack puts the wearer off balance.

People who carry large packs often aren't aware of how much space the packs take up and can hit others with their packs when turning around or moving through tight spaces, such as the aisles of the school bus. Students also are injured when they trip over large packs or the packs fall on them.

How Do You Know If a Backpack Is a Problem?

You may need to put less in your pack or carry it differently if:

• you have to struggle to get your backpack on or off
• you have to lean forward to carry your pack
• you have back pain

If you adjust the weight or the way you carry your pack but still have back pain or numbness or weakness in your arms or legs, talk to your doctor.

Tips for Choosing and Using Backpacks

Here are a few tips that will help make your backpack work for you, not against you:

• Consider the construction. Before you grab that new bag off the rack, make sure it's got two padded straps that go over your shoulders. The wider the straps, the better. A backpack with a metal frame like the ones hikers use may give you more support (although many lockers aren't big enough to hold this kind of pack). Make use of another hiking tip: Look for a backpack with a waist belt, which helps to distribute the weight more evenly across the body. Backpacks with multiple compartments can also help distribute the weight more evenly.
• Carry it well. Before you load your backpack, adjust the straps so the pack sits close to your back. If the pack bumps against your lower back or your butt when you walk, the straps are probably too long. Always pack your backpack with the heaviest items closest to your back. Don't drop all your stuff in the main compartment (using the side pockets will distribute the weight more evenly). Wear both straps over your shoulders. If your pack is really heavy and you can't get around the number of books you need, take some of the books out of your pack and carry them in your hands.
• Try a pack with wheels. Lots of kids use these as an alternative to backpacks, but there are guidelines and considerations to keep in mind with this kind of pack, too. Many schools don't allow rolling packs because people can trip over them in the halls.
• Use your locker. Try not to load up on the textbooks for a full day's classes. Make frequent locker trips to drop off heavy textbooks or extra stuff, like gym clothes or project materials. An added benefit is that you'll get more exercise going back and forth to your locker. Figure out the nonessentials, too. If you don't need an item until the afternoon, why carry it around all morning?
• Plan your homework. Plan ahead and spread your homework out over the course of the week so you won't have to tote all your books home on the weekend.
• Get two sets of books. If your school has extra copies of some of your books, ask if you can borrow them so you can keep a set at home.
• Limit your load. Doctors and physical therapists recommend that people carry no more than 10% to 15% of their body weight in their packs. This means that if you weigh 120 pounds, your backpack should weigh no more than 12 to 18 pounds. Choosing a lightweight backpack can get you off to a good start. Use your bathroom scale to weigh your backpack and get an idea of what the proper weight for you feels like.
• Pick it up properly. As with any heavy weight, you should bend at the knees when lifting a backpack to your shoulders.
• Strengthen your core. A great way to prevent back injury is to strengthen the stabilizing muscles of your torso, including your lower back and abdominal muscles. Weight training, pilates, and yoga are all activities that can be effective in strengthening these core muscles.

Following these tips is the best way to avoid back pain and other problems.

Reviewed by: Kate M. Cronan, MD
Date reviewed: September 2010