What injury is backpack paralysis?

Rucksack palsy is a traction or compression injury to the brachial plexus, caused by the shoulder straps of the rucksack. The patient presents with paresthesia, paralysis, cramping with pain, and muscle weakness of the upper limb. Muscle-strength losses appear to be greater in those carrying heavier loads.



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The condition was first described in 1969 in Vietnam soldiers. 8 The brachial plexus is injured by the weight of the backpack due to direct compression or stretch of the nerve tissue leading to demyelination, with or without axonal injury.

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This type of paralysis can occur when a backpack overloads our shoulder girdle, causing the shoulder blades to sag down dragging the collarbones with them. The collarbones will then compress the delicate long thoracic nerve against our rib cage and it is this nerve compression which causes the paralysis.

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“Backpack syndrome” is a term referring to the various physical maladies associated with wearing a heavy backpack, and wearing one incorrectly. Your child may have headaches and fatigue, or experience numbness in an arm because the backpack is too heavy, the strap is too thin, or it is being carried incorrectly.

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Recovery Time and Treatment In both cases however full recovery will likely take 6 – 12 months and this time period will depend on the degree of initial nerve damage.

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