Perceived school bag load, duration of carriage, and method of transport to school are associated with spinal pain in adolescents: an observational study.

QUESTION Are use and perceived load of school bags and the prevalence of spinal pain different between male and female adolescents? Is use of school bags related to perceived load of school bags? Are use and perceived load of school bags related to spinal pain? DESIGN Cross-sectional observational study. PARTICIPANTS 1202 adolescents recruited from the 'Raine' Cohort Study. OUTCOME MEASURES Use and perceived load of school bags as well as spinal pain were measured by questionnaire. RESULTS The prevalence of back and neck pain was approximately 50%; 53% of females reported neck pain compared with 44% of males (p < 0.01). Almost half of participants carried their school bag for more than 30 minutes per day with 85% carrying their bag over both shoulders. School bags were felt to be heavy by 54% and to cause fatigue by 51%. Carrying a school bag for more than 30 minutes daily and taking an inactive form of transport to school (car or bus) increased the odds of having both back (OR 1.40, 95% CI 1.08 to 1.82) and neck pain (OR 1.47, 95% CI 1.13 to 1.91). CONCLUSION Neck pain is as common as back pain amongst adolescents. Perceived school bag load, duration of carriage and method of transport to school are associated with back and neck pain. Physical activity in the form of walking or riding to school may offset the potentially provocative effects of prolonged bag carriage and warrants further investigation.