Lessons from this study make up what I think is about a third of the solution to effectively treating low back pain preventing future episodes of back pain. That is, to avoid prolonged damaging posture particularly in spine flexion.
Prolonged sitting with spine flexion has been linked to low back disorders. A variety of mechanisms account for this based on biomechanical and neurological variables. Airline seats typically cause pronounced lumbar flexion due to their hollowed seat back design. A pneumatic support, placed between the seat back and the lumbar spine, was tested to see if lumbar flexion was reduced. Results showed that when the seats were positioned in the upright position, 15 of 20 participants experienced reduced lumbar flexion (by 15 degrees on average) with the support. The study was repeated on the five non-responders with the seatback set in the reclined position. This resulted in another four experiencing less lumbar flexion. Since seated flexion is associated with disc stress, reducing flexion with the support reduced lumbar stress. Spine flexion that results from prolonged sitting is associated with disc stress and pain. The pneumatic support tested here reduced spine flexion. While it is not known why airline seats are designed with no lumbar support, which causes excessive lumbar flexion while seated, the pneumatic support corrected this deficit. Reclining the seatback enhanced this effect.
McGill’s studies on the lumbar spine are always good. Although the above paper is in relation to airline seats (which are particularly bad) sitting with various degrees of spine flexion in automobiles, couches and chairs at home, and computer workstations are often problematic as well. Unfortunately if a person is sitting in prolonged spine flexion causing vertebral ligament strain, muscle spasms, posterior disc bulges, and herniations, no amount of exercise is going to completely fix that. More often than not spine stretches will only make matters worse by further destabilizing already overstretched tissues. The good news is that the solution is often simple. A pillow of various size or other object of that fills the gap between a person’s chair and and the small of their back to maintain a neutral spine just requires some awareness of the problem and a bit of imagination. In this case researchers had subjects use an inflatable support, which can be adjusted to a person’s comfort. However when I fly I find the larger in-flight magazine found in the airline seat pocket in front of me, when folded lengthwise, supports my spine just right and I don’t have to worry about packing it or forgetting it. So far 100% of people sitting next to me have agreed it helps prevent in-flight low back pain, and pain upon landing considerably. Best of all, it’s free.
As always, if you have any further questions or need for clarifications, please don’t hesitate to ask. Being aware that some of my blog ideas are contentious and occasionally a bit out of the field of my expertise, I encourage my readers to come forth with any questions/comments that are of interest or concern. Your comments are valued and welcomed.
Chad Reilly is a licensed physical therapist, located in North Phoenix, practicing science based medicine with treatment protocols unique and effective enough to proudly serve patients from Phoenix, Scottsdale, Mesa, Chandler, Tempe, Peoria, and Glendale.