If parents bring in young children complaining of acute back pain, try taking a history that might be just a little more detailed than usual before ordering expensive images or referring. Actually, focusing on one specific question might reveal the answer: Did the onset of pain coincide with the start of the school year? If the answer is “yes,” ask for a detailed list of what goes into the child’s backpack every morning, and how it’s packed. It’s not uncommon for back, neck, or shoulder pain to be caused simply by carrying too heavy a load (or one that’s not packed for comfort and safety). Here’s what to look for—and to counsel parents on:

  • Ideally, the backpack itself should be made of lightweight material like canvas, and have wide shoulder straps and a waist belt to help distribute load bearing. Use both shoulder straps instead of slinging the pack over just one side.
  • Use the backpack’s compartments and side pockets to help distribute weight evenly.
  • Pack heavier items lower and toward the center of the main compartment.
  • If the backpack has wheels, roll it instead of lugging it down the street.
  • Pack light; children should carry no more than 10% of their body weight on their backs. If the pack gets too heavy, take a few books out and carry them separately.

JUCM hosts an Acute Pain Resource Center full of news relating to acute pain management, with an emphasis on nonopoid options.

Back-to-School Shouldn’t Mean Back Pain
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