SAN DIEGO (Reuters Health) - Parents often warn their school-age children not to carry heavy backpacks, worried that they'll get backaches. But a new study has found that the load on the back is often not the culprit when youngsters develop low back pain.

Children with emotional or behavioral problems, as well as those who frequently complain of stomachaches or headaches, are more likely to have low back pain than those who tote around a heavy backpack, researchers reported Sunday at the 10th World Congress on Pain.

Like most experts, a research team from the University of Manchester in the UK figured that heavy backpacks would take a toll on children's back health. "Our hypothesis was that the greater the load, the more low back pain," said Gary Macfarlane, an epidemiologist at the University of Manchester and the lead researcher.

"But we found there is very little difference in risk of low back pain no matter how much you carry," he said. The heaviest backpack in the study weighed about 39 pounds, but most were about 13 pounds. And the kids who carried the heaviest packs, walked to school with them on, and carried them around all day did have a slightly increased risk of back pain.

But the real predictor of back pain was whether the children had emotional or behavior problems, or frequently reported stomachaches or headaches, according to Macfarlane.

"Those with conduct problems were at three times the risk of developing low back pain," he said, compared with those who carried heavy backpacks. "We know that psychological factors can predict the onset of low back pain in adults," Macfarlane said, and this might be true in children as well.

The team went to 39 schools, recruiting children ages 11 to 16. The investigators weighed students' backpacks on 5 consecutive days and asked the students questions about how well they got along with others and other psychosocial issues.

In all, 18.6% of the 903 children surveyed had low back pain.

As for backpack weight, Macfarlane stressed that it is not a good idea to load backpacks to any weight. "We're not saying carry whatever you want," he said. But a backpack weighing up to about 25 pounds, depending on the age and size of the child, is probably fine, he noted.

The American Academy of Pediatrics recommends that backpack weights not exceed 10% or 20% of a student's body weight and recommends wheeled backpacks if possible.

When Macfarlane's research team reviewed medical records of the children with low back pain, they often saw notes advising the parents to caution children about not overloading their backpacks.

The message, Macfarlane said, might also be to keep in mind that the pain may be related to emotional and behavioral problems.

Reference Source 89

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