Schoolbags or backpacks have often been implicated as a cause of back pain in children and adolescents, with some guidelines advising that schoolbags should not weigh more than 10%-15% of the child’s body weight (1).

Recent studies show us that schoolbags (weight, design and carriage method) do not actually increase the risk of back pain in children and adolescents (1,3,4). Studies have, instead, shown that the risk of back pain increases when the child perceives the schoolbag to be heavy or difficult to carry (1,2,4). Other physical and psychological factors that are linked to back pain in children include (3):

  • previous back injury;
  • having a family member that complains about back pain;
  • hyperactivity problems and
  • spending more than one hour in front of the television.

backpacks worn by children don't lead to back painDoes sitting cause back pain?

It is also frequently assumed that sitting “incorrectly” can lead to spinal pain but there is no strong evidence that this is the case. There is also no single correct posture and constantly telling a child/teen to sit up straight may, in fact, increase anxiety which in turn can make any existing back pain worse. Allowing the child/teen to assume a more relaxed posture is more helpful and this relaxed posture/position will vary for each person. It is also important that we know that sitting is not bad or dangerous, but moving and changing positions is definitely helpful (5).



Posture in Children and Adolescents

The poster below gives more information about posture and also looks at new ideas about poor vs correct posture.

Surprising facts about posture

Does exercise help with back pain in children and teens?

Exercise has been shown to reduce the prevalence (6,7) and intensity (6) of back pain in children aged 8 to 13.

If your child is exercising but is still complaining about back pain, we recommend that you make an appointment with your physiotherapist. Your physiotherapist will be able to assess the problem and recommend the best treatment. Complete this easy appointment form to book a session at your nearest Lamberti Practice.


  1. Yamato TP, Maher CG, Traeger AC, Wiliams CM, Kamper SJ. Do schoolbags cause back pain in children and adolescents? A systematic review. British Journal of Sports Medicine. 2018 Oct 1;52(19):1241-5.
  2. Akbar F, AlBesharah M, Al-Baghli J, Bulbul F, Mohammad D, Qadoura B, Al-Taiar A. Prevalence of low Back pain among adolescents in relation to the weight of school bags. BMC musculoskeletal disorders. 2019 Dec;20(1):1-9.
  3. Oka GA, Ranade AS, Kulkarni AA. Back pain and school bag weight–a study on Indian children and review of literature. Journal of Pediatric Orthopaedics B. 2019 Jul 1;28(4):397-404.
  4. Calvo‐Muñoz I, Kovacs FM, Roqué M, Seco‐Calvo J. The association between the weight of schoolbags and low back pain among schoolchildren: A systematic review, meta‐analysis and individual patient data meta‐analysis. European Journal of Pain. 2020 Jan;24(1):91-109.
  5. Slater D, Korakakis V, O’Sullivan P, Nolan D, O’Sullivan K. “Sit up straight”: time to Re-evaluate. journal of orthopaedic & sports physical therapy. 2019 Aug;49(8):562-4.
  6. Fanucchi GL, Stewart A, Jordaan R, Becker P. Exercise reduces the intensity and prevalence of low back pain in 12–13 year old children: a randomised trial. Australian Journal of Physiotherapy. 2009 Jan 1;55(2):97-104.
  7. Hill JJ, Keating JL. Daily exercises and education for preventing low back pain in children: cluster randomized controlled trial. Physical therapy. 2015 Apr 1;95(4):507-16.