Many parents worry that their child’s spinal curvature can be caused by carrying a backpack that is too heavy for them. To determine if these concerns are warranted, we investigated on the first day back to school after summer vacation when students returned to school across the country.
Scoliosis, a type of spinal deformity, can take the form of a single curvature (C-shaped), two curvatures (S-shaped), or even three curvatures (Z-shaped). It is categorized into three types based on the cause of occurrence: congenital, acquired, or caused by injuries or other illnesses. Studies show that this condition affects around 2-4% of children between the ages of 10-16. Although both genders are equally susceptible to scoliosis, it is more prevalent in girls, particularly severe forms that require braces or surgical intervention.
It’s crucial to acknowledge that “scoliosis” and “spinal curvature” are not interchangeable terms since scoliosis involves a curvature in three dimensions. Additionally, there are other spinal conditions such as kyphosis, which is a backward curvature, and lordosis, which is a forward curvature. In some cases, multiple conditions may be present, and doctors may diagnose the patient with kyphoscoliosis or lordoscoliosis.
Non-professionals can often detect severe cases of scoliosis by observing visible physical indicators such as uneven shoulders, protruding shoulder blades, or uneven hips. However, an X-ray is typically necessary to confirm the diagnosis and formulate a treatment plan. Scoliosis is particularly concerning because it can cause breathing difficulties due to the curved chest’s interference with the lungs’ capacity to function properly. Furthermore, aside from back pain and unsightly physical appearance, scoliosis can result in severe health complications.
Let’s examine the causes of scoliosis. Congenital scoliosis is a condition that presents itself at birth, as suggested by the name. The pathology cannot be attributed to carrying heavy backpacks as the condition results from a disruption in intrauterine development or genetic disorders. For instance, scoliosis is often observed in individuals with Down syndrome, Marfan syndrome, and spina bifida.
Post-traumatic scoliosis can occur at any stage of life and, as the name suggests, is a condition that develops after a traumatic event, usually a spinal fracture. This type of scoliosis is not associated with carrying heavy backpacks.
The third type of scoliosis, known as acquired or idiopathic scoliosis, is the most prevalent, accounting for 80% of diagnosed cases. The term “idiopathic” implies that the cause of the condition is unknown. It is likely this unknown cause that has led to the misconception that carrying a heavy backpack or maintaining incorrect posture and a lack of physical activity may cause scoliosis. However, none of these factors are listed as potential causes of scoliosis on reputable sources such as the Mayo Clinic’s website, the UK National Health Service, and the British Scoliosis Association’s website. The American Academy of Orthopedic Surgeons also addresses the question of whether a backpack can cause scoliosis on its website, and experts clearly state that there is no correlation between backpacks and scoliosis.
It is important to note that carrying a backpack that is too heavy can cause discomfort and pain in the back and lower back, even though it is not a direct cause of scoliosis. As per the American Academy of Pediatrics’ recommendations, a backpack’s weight should not exceed 15% of the student’s weight.
There is a common misconception that carrying a backpack on one shoulder can exacerbate back or lower back pain. However, scientific studies have shown otherwise. Greek doctors observed 3,441 students between the ages of 9 and 15 who reported experiencing back and lower back pain after carrying a backpack. The scientists found no correlation between the frequency and intensity of pain and the way the backpack was worn, whether on one shoulder or both.
There is growing evidence suggesting that idiopathic scoliosis may be caused by a specific set of genes. For instance, a meta-analysis of 50 studies investigating genes presumed to be linked to this condition identified 34 candidate genes. However, our understanding of how genetics affects spinal curvature is still far from complete.
Based on current scientific knowledge, it is clear that a school backpack, even a heavy one, cannot cause scoliosis. Nevertheless, it is still important to follow weight guidelines to avoid back and lower back pain that can result from carrying an excessively heavy backpack.
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