Backpack Use as a Risk Factor in Children's Back Pain

¹A.I. duPont Hospital, Wilmington, DE, ²Johns Hopkins University, Baltimore, MD, USA

INTRODUCTION: The prevalence of nonspecific back pain increases dramatically during adolescence from ‹ 10% in preteens up to 50% in 15-16 year-olds. The purpose of this ongoing longitudinal prospective study is to investigate the relationship between backpack use and back pain in adolescents.

METHODS: 817 children between the ages of 12-17 participated in this study by completing a questionnaire about their health (including scales from the Child Health Questionnaire), activities, and backpack use. Measurements of children's height, weight, and backpack weight were obtained. For the purpose of this study, a child was classified as having back pain in the past 4 weeks if one or more were reported:

·Neck/back pain that interfered with school or leisure and rated pain great than or equal to 2
(scale=0-10)

·A visit to a doctor/therapist for neck/back pain

·Excused from physical education/sports because of neck/back pain

Multivariate logistic regression was used to assess the significance of factors associated with back pain while simultaneously adjusting for other variables in the model.

RESULTS: 76.3% of 682 children analyzed to date were classified as having back pain, validated by having significantly poorer general health, more limitations in performing physical activities and more bodily pain, as assessed by the CHQ. Compared to low or no use of backpacks during the school day, moderate use (odds ratio=1.9, p=0.012) and high use (odds ratio=3.2, p ‹ 0.0001) were associated with back pain. Female gender and greater body mass index also were significantly (p ‹ 0.001) associated with back pain. Statistically significant associations were not found between back pain and backpack weight or between back pain and the ratio of backpack weight to body weight.

CONCLUSION: Statistically significant associations were found between back pain and backpack use, female gender, body mass index, general health, physical functioning, and bodily pain. Statistically significant associations were not found between back pain and backpack weight or between back pain and the ratio of backpack weight to body weight. Further study is ongoing to delineate the role of backpack usage in children's back pain.