Shoulder pain from carrying a bag usually comes from a heavy load hanging on one shoulder for a long time, which presses on the top of the shoulder and keeps the neck and shoulder muscles working to hold it up. A common guide is to keep a backpack under about 10% of your body weight, use both straps, and switch sides with a one-shoulder bag every 10 to 15 minutes. Lighter and closer to the body is easier on the neck and shoulders.
Most bag-related pain eases once the load changes. It is also a useful clue: if pain follows the bag, the bag is part of the cause.
Key takeaways
- Weight: a common guide is to keep a backpack at or under about 10% of body weight, and a one-shoulder bag lighter than that.
- Two straps: a backpack on both shoulders spreads the load and keeps the spine more upright.
- Strap fit: wide, padded straps, tightened so the bag sits high and close to the back.
- Switch sides: with a shoulder bag, change sides every 10 to 15 minutes, or use a cross-body strap.
- Common problems: neck and upper shoulder muscle strain, and less often pressure on nerves at the top of the shoulder.
- Time to ease: bag-related aches often ease within days and settle over 3 to 6 weeks once the load changes.
How to carry with less strain
Know the weight
Weigh yourself holding the bag, then without it. The difference is the bag.
- Backpack: aim for about 10% of your body weight or less. For someone who weighs 150 lb (68 kg), that is about 15 lb (7 kg).
- One-shoulder bag or tote: keep it lighter, ideally under about 5% of body weight, or about 7 lb (3 kg) for the same person.
- Laptop bags: a laptop, charger and water bottle alone often weigh 6 to 9 lb (3 to 4 kg).
These are general guides, not strict limits. If your neck or shoulder is already sore, lighter is better.
Backpacks
- Both straps: wearing a backpack on one shoulder puts the whole load on one side and makes the body lean to balance it.
- Height: tighten the straps so the bottom of the bag sits at or above your waist, not hanging toward your buttocks.
- Close to the back: pack the heaviest items nearest your spine.
- Chest strap: if the bag has one, fasten it to stop the straps sliding toward the edge of the shoulders.
- Hip belt: for heavier loads, a hip belt moves some of the weight onto the pelvis.
Shoulder bags, totes and handbags
- Cross-body: wearing the strap across the body, over the opposite shoulder, spreads the load better than hanging it from one shoulder.
- Wider straps: a strap about 2 inches (5 cm) wide or more presses less on one spot at the top of the shoulder.
- Alternate: switch sides every 10 to 15 minutes, before the ache starts.
- No hitching: if you keep shrugging your shoulder to stop the strap sliding, the bag is too heavy or the strap too thin.
Shopping and heavy loads
- Split it: two lighter bags, one in each hand, balance better than one heavy bag.
- Close to the body: hold bags close to your sides with the elbows slightly bent, not hanging at arm’s length.
- Wheels: for long distances or heavy loads, a bag on wheels takes the weight off the shoulders entirely.
If the pain follows the bag, lighten the bag before anything else.
Common mistakes
- Packing for every day of the week: books, chargers and spare items that are carried but not used.
- One strap on a backpack: convenient for a short walk, hard on the neck over a long commute.
- Long straps: the bag swings and hangs low, pulling the shoulders down and forward.
- Shrugging to hold the strap: this keeps the upper trapezius working the whole time.
- Carrying through pain: pushing on with the same load when the shoulder already aches.
How long changes take to help
Once the load is lighter and better spread, many people notice less aching within a few days. Muscle strain from carrying often settles over 3 to 6 weeks. If you have had numbness or tingling from a heavy strap, it often eases over days to weeks once the pressure stops, but if it lasts longer than about 2 to 4 weeks it is worth having it checked.
Where else this could be coming from
- Neck muscle strain: an ache from the side of the neck to the top of the shoulder, worse at the end of the day.
- A pinched nerve in the neck: pain or tingling running down the arm, often worse turning or tilting the head toward the sore side.
- Nerve or blood vessel compression at the top of the chest (thoracic outlet syndrome): heaviness, tingling or a tired arm with carrying or reaching overhead, often in the little-finger side of the hand.
- Rotator cuff problems: pain at the outer upper arm, worse lifting the arm sideways or reaching up.
- AC joint irritation: a sore spot at the top point of the shoulder where the strap sits, worse reaching across the body.
- Elbow, wrist or hand pain: if carrying by hand hurts mainly below the elbow, the cause may be lower down the arm.
Get it checked if
- Emergency: call your local emergency number if left shoulder or neck pain comes with chest pain, breathlessness, sweating or nausea, especially if it starts with exertion.
- Today: see a doctor today if the arm suddenly becomes swollen, discolored or cold, or if you notice weakness in the arm that is getting worse.
- Soon: get it checked if tingling or numbness in the arm lasts beyond 2 to 4 weeks after lightening the load, if your shoulder blade starts to stick out, or if pain is not easing after 4 weeks.
More on this area: desk and sleep guides.
Lighter, closer and shared across both sides is easier on the neck and shoulders.
Written by Louise Yow, Neck & Shoulder Physio.