Planes, Trains, Automobiles and Back Pain

Avoiding back pain on your summer holiday vacation
Avoiding back pain on your summer holiday vacation

It's that beautiful time of year when we get to take a vacation.  Whether it's long haul or an hour from home, trekking amoung ancient ruins, exploring the hidden streets of a european city or chilling out on the beach - you want to make sure that back pain doesn't wreck your time away.  You might think that vacation is the last place that injury or pain can strike - you are in a beautiful place, your time is your own, you are happy and relaxed.  How could you possibly get injured?  In part 1 of this article I discuss why back pain can occur during the travelling part of your trip and give you tips on how to minimise the chance of you experiencing back pain so you can enjoy every moment of the vacation that you have worked hard for all year and that you thoroughly deserve!

Why is sitting so bad for the back?

The low back has a natural lordotic curve which helps the intervertebral discs stay centred between the vertebrae.  When you sit the low part of the spine becomes rounded and the lordotic curve is reversed.  Curving the spine for long periods encourages ligamentous creep (read more about this theory here) - the stretching of structural stabilisers that help keep your discs and spine aligned.  Ligaments can be stretched but they do not return to their original length.  Over time the spine becomes unstable and the discs can push out on to the nerves causing discomfort.  Instability of the segments means unwanted movement which can also create problems.

Sitting for long periods also causes compression of the spine.  Depending on what position you sit certain parts of the spine may take more pressure than others which can result in certain muscles taking on more work than necessary whilst others switch off.  This can cause discomfort also.

Travelling to your destination often requires sitting on a plane, on a train or in the car.  The back doesn't like sustained postures like sitting in a chair for several hours.  For each situation you might find yourself in there are a few changes you can make to make your back more comfortable.  So here are my top tips for minimising back pain on your vacation this year.

In the driving seat

Car seats are not great for back pain.  The back seat is often slanted downwards which means your hips are lower than your knees when seated.  This is especially true in supercars such as the bugati, porsche, maserati, ferrari and maclaren which are set very low to the ground.  The first thing you can do is change the angle of your seat so that the back of the seat is higher than the front.  If this is not possible i advise my clients to get a wedge cushion and place the raised part at the back of the seat.  This will help to raise the hips higher than the knees and place the spine in  better alignment thus reducing the risk of discomfort.


Another common problem is that car, plane and train seats do not give adequate low back support.  I recommend to all my clients who have disc injuries that they invest in the Mckenzie inflatable back support for their car seat.  Place it in the mid part of your low back opposite your belly button and inflate to a size that makes your back feel supported - everyone will need a slightly different adjustment but aim for supper that keeps your back neutral.  This means a slight arch in your low back.

I like to move it move it

The third and most important part of avoiding low back pain when travelling is to take regular breaks to move around.  That means actually moving around not more sitting at a service station for a cup of tea or walking for 10 seconds to your friend at the back of the plane or the other train car and sitting with him for a natter.  Walk around, stretch, mobilise and move as much as you can where you are.  If you are travelling by car and you take regular breaks I know it takes longer to get to your destination and if it means making the choice between two weeks of discomfort and grumpiness over two weeks of happy, relaxed fun... I'll let you make the decision on that one! 

Switch it up baby

On the plane if you have the option to recline and lie down alternate between reclining, sitting up and lying down as this counts as changing your position.  If you are particularly tall opt for a business class seat with more leg room or at the very least the front row of economy class.  If you are already in discomfort a seat which allows you to fully recline on the plane is your best option as this is where pressures and forces on the spine are at their lowest.  Regularly stand up and walk the aisles of the plane even if your flight is a couple of hours.  Movement is absolutely key to keeping discomfort to a minimum.  Don't wait until you feel uncomfortable - take a walking break every twenty minutes.  I often find drinking lots of water helps as I need to use the restroom a lot which means getting up.  It also helps you stay hydrated...

Water your back

Whatever mode of transport you are taking drink lots of water - not juice or tea or coffee - WATER.  The discs of the spine are filled with fluid.  When you are dehydrated they reduce in height which means the vertebrae are more likely to cause compression of the nerves where they exit the spine.  Staying hydrated helps keeps the discs plump and maintain good height.  Hydration is also one of the most important parts of good health so never skimp on water!

In Part 2 of this article I discuss the culprits of back pain when you have actually arrived.  If you can't wait then click here to read it.  I wish you all happy and safe vacations wherever you are relaxing, exploring or going a little crazy!  Remember these essential factors to minimise back pain occurring and look out for my article on safely returning to exercise post vacation which I am writing for The London Orthopaedic Clinic.  It should be out when you are all back to your London routine!