Back Pain & Strain: How to Prevent it!

**Not medical advice** Copyright Max Wettstein 2012

     Back trouble is an occupational hazard for us pilots.  A lot of us just deal with it – practically ignore it – because we are so accustomed to it.  Back pain is the leading disability in Western industrial countries, so we’re not the only ones facing this epidemic, but we’re at greater risk then many.  The reason why pilots are so often affected by back trouble is no big mystery.  Just like many of the other health issues we deal with, it is a result of all of the sitting we do.  No matter how good of shape we are in, or how healthy our backs normally are, you can be sure that if you fly a long enough trip, your back will at the very least, not feel 100% by the last day of your pairing.  Flying is hard on the back even if you do not have a back problem.

     The spine is structured with 3 natural support curves, being the cervical (neck), thoracic (upper back), and the lumbar (lower back).  These curves are responsible for distributing your upper-body weight evenly, and contribute to the spine’s overall flexibility.  When you stand naturally, the weight of your upper-body is transmitted by the lumbar vertebrae, (the large bones of your lower spine), around your pelvis to your leg joints, then down your legs to your feet and into the ground.*  But when you sit down, your pelvis rotates backwards, and the weight of your upper body is borne by your lumbar spine.*  This puts immense strain on the discs of cartilage that separate the lumbar vertebrae, on the ligaments that tie them together, and on the muscles that hold them upright.*  Poor sitting posture, slumping, or slouching, load up your lumbar spine with even more strain.  It is possible to sit properly so that the spine’s natural curves are maintained, and by doing so you can minimize your risk of back pain and injury.

      If you’re not maintaining good sitting posture, or are sitting for a very long period without standing up or shifting your position, backache may start to develop as a sign of lumbar strain, especially during a transcon.  This is usually not an acute type of injury or pain, but more of a chronic build-up of strain over time.  If left unchecked however, a severe back condition could develop.  Many of us are guilty of enduring back pain for years and see a doctor only when the pain is unendurable.  By that time, severe twinges, and spasms can develop, and you will most likely need professional medical attention for pain relief, if for no greater reason.  Excruciating pain may indicate a disk is pressing on a nerve, a disk is slipped or herniated, although injuries this severe are usually caused by trauma such as improper lifting or from other physical activity.  The latter could result in nerve impingement so severe, that mobility may be impaired.  Surgery may be the only way of correcting conditions this serious.

     As previously mentioned, we are also at risk for traumatic injury from lifting luggage with improper body mechanics.  Especially when carrying bags up the air-stairs or lifting them into overhead bins for our customers.  These injuries may be associated with acute, sharp pain, and can be severe, but typically results in muscle strain.  Again, excruciating pain may be in indication of a slipped or herniated disk.  Whether your pain is the result of chronic build-up or acute trauma, if you experience any of the following symptoms you should seek professional medical attention: Twinges somewhere in your back that seem to have become more frequent and often shoot down your buttock or leg; Your lower back aches much more than it used to and the pain is more intense, requiring you to lay down; You get bouts of back pain with numbness, tingling, or stiffness in your legs, feet, arms, or hands.*

     Okay, so enough of the bad news.  Let’s talk about prevention.  If you do not experience back pain and never have, keep doing whatever it is your doing.  When it comes to chronic backache, you can help yourself most by getting up and moving around in the cockpit every so often and carefully stretching your back.  Bend forward, place your hands on your knees and alternate rounding out your back and then arching it into a ‘C’ position.  Anyone with Yoga experience will be familiar with this stretch.  Bend further forward and reach for your toes and stretch your hamstrings.  Do this slowly and do not force yourself.  When you get back to the hotel, lay on the floor, bring your knees to your chest, and roll back and forth for about a minute.  The next thing you can do is to sit with proper posture, which allows your spine to maintain its natural structural curves, especially the lumbar.  This does not mean sitting like a statue the entire time, because squirming and shifting your sitting position is actually good for your spine, and circulates spinal fluid.  For the majority of your time spent sitting, sit with your sacrum, (tailbone at the base of your spine), directly against the seatback.  Then, using the nifty lumbar supports our A320 seats have, adjust the support forward and up enough, so that the inward curve of your lumbar is maintained, and your pelvis will not be tilted backwards.  This keeps the weight of your upper body loaded on your pelvis and your ‘sits’ bones, (a Yoga term for the ischial tuberosities on the bottom of your pelvis), and not on the lumbar spine.  If required, grab a pillow from the cabin for extra lumbar support.  Keep your pelvis against your seat back even when reclining your seat back.  Sit dynamically, meaning alternate your position every so often, as well as using your footrests from time to time.  And don’t forget to stand and stretch.  Lastly, if you’re currently injury and pain free, don’t forget exercise to maintain and strengthen the muscles and ligaments that hold your spine upright.  This way, a few hours spent sitting, or lifting a customer’s bag up into the overhead bin without bending your knees, is less likely to ‘throw your back out’.                                                                                                                                

     When lifting luggage, take the time to use proper body mechanics.  We all know by now that we must lift with our legs by bending at the knees first.  Also, be sure to maintain a ‘C’ – shaped arch in your back and flex your torso muscles as you prepare to lift, and, hold the bag close to your body.  Inhale prior to lifting and exhale as you complete the lift.  We all want to show our customers great JetBlue hospitality, but if you’re unsure of your back, you should get additional help.   

      If you injure your back while lifting luggage, or you find you are feeling pain after your flight as a result of too much sitting, you may want to consider massage, heat treatment (warm bath or shower, analgesic creams), and/or anti-inflammatory drugs (NSAIDs such as Ibuprofen).  When you go to sleep that night, sleep on your back with a pillow under your knees.  If the pain persists for more than a day, or worsens into spasms or twinges, you guessed it, go see a doctor.

     A lot of this is common sense, but the problem is we get too tired to sit correctly, or even care for that matter.  Our attitude becomes one that accepts a little backache as just being part of the job and not a big deal.  We become stoic.  The problem with this mentality is that cumulative, long term damage may be taking place, which may not manifest itself for years.  We need to be aware and take action now, or we could be left flat on our backs later.

Back to Max's TRAVEL FITNESS Page