One of the fundamental pieces of any back-to-school ensemble is, of course, the backpack.

Although they are practical, backpacks are a leading cause of back and shoulder pain for millions of children and adolescents. As students head back to school, here is some advice on preventing backpack pain and injuries:

• Is the backpack the correct size for your child? The backpack should never be wider or longer than your child's torso, and the pack should not hang more than 4 inches below the waistline. A backpack that hangs too low increases the weight on the shoulders, causing your child to lean forward when walking.
• Does the backpack have two wide, padded shoulder straps? Non-padded straps are uncomfortable, and they can place unnecessary pressure on the neck and shoulder muscles.
• Does your child use both straps? Lugging a heavy backpack by one strap can cause a disproportionate shift of weight to one side, leading to neck and muscle spasms, low-back pain, and poor posture.
• Are the shoulder straps adjustable? The shoulder straps should be adjustable so the backpack can be fitted to your child's body. The backpack should be evenly centered in the middle of your child's back.
• Does the backpack have a padded back? A padded back not only provides increased comfort, it also protects your child from being poked by sharp edges on school supplies (pencils, rulers, notebooks, etc.) inside the pack.
• Does the pack have several compartments? A backpack with individualized compartments helps position the contents most effectively. Make sure that pointy or bulky objects are packed away from the area that will rest on your child's back, and try to place the heaviest items closest to the body.

The American Chiropractic Association recommends that parents or guardians help children pack their backpacks properly, and they should make sure children never carry more than 10 percent of their body weight. For example, a child who weighs 100 pounds should not carry a backpack heavier than 10 pounds.

Even though this can be difficult considering the number of books children have to carry, a system can be developed to minimize the weight most of the time.

In addition, parents should ask their children to report any pain or other problems resulting from carrying a backpack. If the pain is severe or persistent, seek care from your local doctor of chiropractic or other healthcare professional.