Traveling requires us to use our bodies in ways we’re not used to, such as hoisting luggage over our heads into the bin and yanking it off the moving baggage claim. It requires us to sit still for long periods, often in a cramped space.
No wonder people with back pain and other types of pain avoid travel whenever possible. To help you have as pleasant a trip as possible, here are a number of things others have tried and found to work well:
Be smart about luggage
Lift luggage in stages. Move slowly when lifting your luggage and break the action into smaller parts. For example, when lifting a bag into an overhead bin, it can first be lifted to the arm of the seat, then to the top of the seatback, and then into the bin in separate motions.
Never twist while lifting. This is a common cause of injury to the low back. Pivot with your feet so that your whole body moves instead of just twisting your back.
Better yet, avoid lifting. Ask a flight attendant for help. If you explain you have a back condition, you will be surprised how helpful the airline staff will often be. If your bags are small and light, it will be less of a burden to ask someone to help you.
Ship ahead. This is my favorite solution for luggage: just mail your essentials to your destination ahead of time. This way you avoid luggage entirely and can carry just one small bag onboard with you. No schlepping. No hassle. No pain.
Pack light. Use 2 or 3 smaller bags rather than one large, heavy bag, especially if you will have to lift the bags in or out of car trunks, off airport baggage carousels, into and out of overhead bins, etc.
Use a backpack. Do not sling a bag over one shoulder (unless it is a very light handbag). Use a good quality lightweight backpack. Use both straps. The generally recommended maximum weight of a backpack is 10-15% of your body weight and even less if you have a painful back. Using a backpack has the added advantage of leaving your hands free to hold onto handrails on escalators, stairs, the boarding ramp, etc.
Plan ahead for medication
Get a prescription. If there’s any chance you may run out of your medication while you’re traveling, get a prescription from your doctor and bring it with you so that you can buy more when required. Remember that in foreign countries the medication that you usually take may have a completely different name.
Keep your medication with you. This may be completely obvious, but it’s worth saying anyway. Make sure you keep all your medication with you in flight and do not check it in with luggage. Don’t just bring the medication you think you’ll need for the flight, as you and your luggage may get separated indefinitely, or your flight could get seriously delayed or be worse than expected.
Bring an OTC backup. As a backup, bring acetaminophen (such as Tylenol) and ibuprofen (such as Advil, Motrin or Nuprin). If your pain medicine runs out, these two can be taken together and have a powerful pain relieving effect. Neither requires a prescription. Of course, check with your doctor before doing this.
Keep medications in their containers. Don’t put different medications into the same containers. Keep each type of medication in its prescription bottle. In some situations, you could be detained in security for traveling with pills that aren’t in separate labeled containers.
Use easy pain relief tactics
Ice is key. There are many ways to make sure you have access to ice/cold to numb the lower back when traveling. The simplest is to bring extra Ziploc bags and whenever you need to, ask a flight attendant to fill it with ice for you. Place it between your lower back and the seat. Leave it on for 20 minutes to numb the lower back and repeat as needed. You can also use cold packs that are manually activated. If security will let you, bring a small gel ice pack on the airplane. Flight attendants will keep them in the fridge for you.
Heat helps too. There are disposable, portable hot packs that heat up after you open them, so you can bring them on your travels and open and apply them as needed. Commercial heat wraps, such as ThermaCare, incorporate heating units across the low back area of the band. Such types of heat wraps last for several hours, making them ideal to provide back comfort during lengthy travel. If you want to bring gel heating packs, first check with your airline to see if they’re allowed past security.
OTC pain patch. Consider using a non-prescription pain patch, (such as the Bengay Pain Patch). It may reduce your need for pain medications. Of course, check with your doctor before using these patches.
TENS units. For some people, a TENS unit can reduce pain. Get a letter from your physicians or physical therapist explaining your condition and the need for the TENS unit and what it is, as this may be needed to help you through security or to provide information to the flight crew.
Consider muscle relaxants. Consider talking with your doctor about muscle relaxants that you can take before a plane trip. They may be helpful if you have a long plane ride ahead of you.
Actively seek help from the airlines
Get an aisle seat. Ask for an aisle seat out of medical necessity (stress medical necessity). It is easier to get into and out of an aisle seat, and it allows you to get up and move around the cabin more easily. Since back pain can’t be seen, traveling with a letter from your doctor that explains your condition will help you get accommodations such as an aisle seat.
Get wheelchair assistance. Make sure the airline knows you are handicapped so they will wheel you around with a wheelchair. You won’t have to carry your bags, walk to the gate, or stand while waiting in line at security. It is best to do this when you make the reservation. You just need to ask for wheelchair assistance to the plane door. Even if it is supposed to be just a short walk to the gate, remember that gates can change, there may be a lot of standing in line when going through security, and other issues may arise that would make a wheelchair worthwhile.
Ask for a row of seats. If the airplane isn’t full, when booking see if you can get the last row of seats (which usually no one else wants). Then you can pull up the seat arms and lie down.
Recline. For many back conditions, sitting in a slightly reclined position is least stressful on the back. If this is the case, remember to check that your seat will recline when making your reservation and getting a seat assignment. Some seats in exit rows or at the back of the plane do not allow you to recline.
Stretch key muscles. Sitting for extended periods can cause stiffness and tension in the hamstrings (the muscles in the back of the thighs) and hip flexor muscles, which in turn puts added stress on the low back. Ask your doctor for a few safe hamstring and hip stretches you can do while traveling.
Pre-board. Make sure the gate agent knows you will need to pre-board. Conversely, if sitting for a moment longer than necessary will be unbearable, board last. If you do this, make sure your carry-on can fit beneath your seat, because if you board last the overhead bins might already be full. If you are worried about the overhead bins being full, ask if you can check your carry-on at the gate.
Consider a handicapped parking sticker. If you will be parking at the airport but have trouble walking very far, you can ask your doctor to fill out an application for a handicapped parking permit.
Avoid getting bumped. Due to overbooking, a practice that seems to be common lately, getting a seat assignment in advance can reduce the risk of getting bumped from your flight. If no seat assignment is given when you buy your airline tickets online, call the airline to get a seat assignment immediately. If you arrive at the ticket counter without a seat assignment on an overbooked flight, you probably will get bumped off the flight and be forced to take a later flight, which can be several hours or even one or two days later.
Sit with support
Fix the seat. Place a small rolled-up airline pillow, blanket, towel, or lumbar pillow between your back and the seat to support the natural inward curve of your lower back. You may also use commercial low back supports if you prefer. Supporting the curve in your low back is especially important with many airplane seats, as they are often worn out and force your lower back to an unnatural, stressful position. If the bottom of the seat is concave from too much use, place a folded blanket on the seat.
Use your feet. Bottom-up leverage from your feet is also required to support your low back. While seated, your knees should be bent at a right angle. If your seat is too high, place your feet on something that can act as a firm footrest, like a book or box, to keep your knees at a right angle and avoid stressing the low back.
Bring a letter. Obtain a letter from your physician explaining your condition, medications, and treatment requirements. This can come in handy in many ways: when requesting an aisle seat, wheelchair assistance, getting your medications through security, requiring medical care while traveling, etc.
Drink water. Water circulates healing nutrients and oxygen throughout the body. Drink water frequently to help keep your pain at bay and to keep your body hydrated.
Get up and move. Sitting in one position for extended periods of time stiffens the back muscles, which can put stress on the spine. Get up to stretch and move around every 20 to 30 minutes if possible. Movement stimulates blood flow, and blood brings important nutrients and oxygen to your back, which reduces stiff muscles and helps curb inflammation. Movement also helps prevent blood clots from forming in the leg (called deep vein thrombosis), which is one of the most dangerous risks of sitting still for long periods.
Wear slip-on shoes. Wear high quality, comfortable supportive shoes if you will be walking distances through airports, train stations, etc. Slip-on shoes are easy to slip on and off without having to bend over when going through security.
I also advocate diversions to help keep the pain at bay, especially if traveling will be stressful for you. One option is to treat yourself to something special like a great new book or a movie during the flight. Another option is to do something for someone else (write a letter to an elderly relative or neighbor, write down memories of your children, etc.) to focus your mind elsewhere.