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Ask Dr. Sears: Backpack Pain

Q. My fifth-grader is complaining of back pain, and I think it's due to the number of books he carries in his backpack. Can this cause irreversible damage? Also, what can we do to prevent back problems in the future?

Your suspicion is probably correct. Back pain is unusual, especially in young children, but when it does occur, one of the most common causes is a backpack that is too heavy and being carried improperly. Luckily, this is one of the most preventable and treatable causes of childhood back pain. Here's how you can help your child:

Get an extra set of books. If he's lugging heavy books between home and school every day, see if it's possible to borrow or buy an extra set of the heaviest books to keep at home. While this may be the most costly remedy, it will be the most effective.

Limit the load. The general recommendation of orthopedists is that a child's backpack and its contents weigh no more than 10 percent of the child's usual body weight. So, if a 10-year-old child weighs approximately 70 pounds, the maximum weight of the backpack and its contents should be seven pounds. A study of 345 children in grades five through eight showed that 55 percent carried loads heavier than 15 percent of their body weight. One-third of these children reported back pain severe enough to cause them to miss school or visit a doctor. Put your child's typical backpack load on your bathroom scale  -- you're likely to find that it weighs much more than it should.

Pick the safest backpack. Another study, of 1,700 Los Angeles schoolchildren, found that carrying a backpack by only one strap caused the most pain. At the very least, it's important to buy a backpack that has two straps. Even better is a model that also has a waist belt  -- it helps distribute the weight more evenly. Be sure the shoulder straps are padded and wide. While it may not win cool points with your child, a backpack with wheels will give the most immediate relief. Or, have him use a hiking backpack with a metal frame that will distribute the weight more evenly across the back of the hips.

Pack the backpack wisely. Put the heavier items in first so they are situated lowest in the bag. You want most of the weight to rest over the top of the hip bones, as opposed to the upper back, which causes greater back strain.

Strengthen the back muscles. Doing sit-ups can work wonders, as they strengthen the abdominal muscles. Also, swimming (especially the breast stroke) is a safe and easy method to strengthen back muscles. Another effective exercise is to have your child lie on his stomach on the carpeted floor and raise his head and feet a few inches off the floor and hold for ten seconds, several times.

Pick up the backpack properly. To further minimize backache, teach your child to always bend at the knees, rather than bending over stiff-legged from the hip, when picking up heavy objects.

If these suggestions don't ease the back pain within a week or two, have your child examined by his doctor. A simple X-ray of the spine will ensure that there aren't any developmental problems in the bone that could be causing his discomfort.