The Impact of School Bag’s Weight on Musculoskeletal Symptoms in Secondary-Level Students

Abstract

Background: Musculoskeletal disorders (MSDs) among adolescents are a growing public health concern, particularly those arising from carrying heavy school bags. Secondary-level students are at increased risk due to ongoing musculoskeletal development, suboptimal posture, and prolonged exposure to biomechanical stress from schoolbags. Objective: This study aimed to examine the relationship between school bag weight and musculoskeletal symptoms among secondary-level students in Bangladesh. Methodology: A cross-sectional descriptive study was conducted among 280 students aged 13–17 years from two secondary schools. Data were collected using a semi-structured questionnaire, objective body and bag weight measurements, and the modified Nordic Musculoskeletal Questionnaire (NMQ). Descriptive and inferential statistics, including Pearson Chi-square tests, were applied using SPSS 25. Results: The mean body weight of participants was 51.94 kg, and the average bag weight was 4.31 kg. A significant proportion (67.5%) of students reported musculoskeletal pain, predominantly in the shoulder (60.7%), neck (35.7%), and back (18%). The prevalence of pain increased with bag weight; 78.2% of students with heavy bags experienced discomfort, compared to 32.1% with lighter loads (p<0.001). Poor posture, prolonged carrying duration, and asymmetrical carrying methods further exacerbated symptoms. Discussion: The findings reveal a strong association between excessive school bag weight (particularly 7–15% of body weight) and musculoskeletal symptoms. Although many students used both shoulders for carrying, this did not eliminate pain risk, highlighting the multifactorial nature of the issue. The study underscores the importance of ergonomic education, bag weight regulation, and school infrastructure improvements to prevent MSDs among students. Keywords: Schoolbags, Musculoskeletal symptoms, Adolescents, Ergonomics, Backpack weight, Postural stress.