Three Children with neon coloured backpacks walk down a busy city street.

Myth or Fact: Is a Heavy Backpack Bad for You?

pt HealthLimb pain, Neuropathy, Shoulder pain

With the start of the school year, we’re often asked: “is carrying a heavy backpack bad for me?” While there are a lot of variables that go into answering that question, one thing we can say for sure is that carrying an excessively heavy bag, backpack, or rucksack can cause compression on your brachial plexus (the network of nerves running down the front of your shoulder). This condition is sometimes known as backpack palsy, rucksack palsy or rucksack paralysis and is a condition caused by carrying heavy backpacks. If you or your children frequently wear a very heavy backpack and are experiencing weakness or pain in the shoulders, arms, forearms or hands, you may have this condition. Today we’ll discuss symptoms, causes, and treatments.


While backpack palsy is most common for hikers, backpackers, boy scouts, or soldiers, there are cases of children and young adults experiencing the condition too. Symptoms vary depending on severity but commonly affect the upper body including the arms, hands, forearms, or shoulders. If you have backpack palsy, you may experience these symptoms after carrying a heavy backpack or carrying one incorrectly:

  • Weakness (paresis) in the arms, hands, forearms, or shoulders
  • Numbness in the arms, hands, forearms, or shoulders
  • A tingling, tickling, prickling, numbness or burning sensation (paresthesia)
  • Pain in the arms, hands, forearms, or shoulders
  • Pain that radiates down the arm
  • Muscle wasting in the shoulder, arm, forearm, bicep, or hand muscles


The main cause of backpack palsy a heavy backpack putting too much pressure on the brachial plexus. These nerves are responsible for sending and receiving signals from the spinal cord to the shoulder, arm, and hand. When compressed you get the numb, tingling, weakness in your arms, hands, or shoulders. You could be compressing your brachial plexus if you:

  • Overload your backpack
  • Do not use waist support or only use one strap
  • Wear your backpack too low or loose
  • Have underdeveloped shoulder muscles
  • Have pre-existing conditions or injuries to the shoulder


If you are experiencing numbness, weakness, or tingling in your arms, hands, or shoulders after carrying a backpack, you should seek an assessment from a physiotherapist. When caught early, “The prognosis is good with almost complete recovery in 80% of the patients, two-thirds within two to five months.”[i] Treatment for backpack palsy is simple and straightforward, non-surgical physiotherapy-focused treatments for backpack palsy include:

  • Stretching and strengthening exercises
  • Stretching and strengthening exercises
  • Activity modification (not carrying a heavy backpack anymore!)

If caught and treated early and effectively you can see an improvement in symptoms within a relatively short period of time. If you think you might have backpack palsy it’s best to book an appointment with a qualified physical therapist to get a full assessment and treatment plan in place– no doctor referral needed!*





*A doctor referral may be required to access your third party insurance.


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