I had my friend make a belt for me. He worked in a shop as a fabricator. So he took an old weight lifting belt I had, put two rivets on each end and fitted some metal rings. Then I would just attach a chain and carabiner. The quality of this belt is 10x that of your average belt, very heavy duty
Suppose the backpack is of good quality and has a good back panel. It should be orthopedic and put pressure in the necessary places. I have several, but my favorite is Drawstring Bulk Bag from Amazon. It is not orthopedic, but I like it because it is the most comfortable one for me. It is waterproof and customizable, and I am used to it. This is the main reason I use it – I am used to it and like it. I like how it looks, and I can combine it with most of my looks. So, you better choose the backpack you like most, and you will never forget to take it with me.