Back Pain from Driving
/A car seat is not a chair. Five minutes with the seat controls before you pull out changes the next few hours more than anything you can do while moving.
Why driving is harder on a back than sitting in a chair
At a desk you shift constantly without noticing. In a car most of that is taken away: your right foot lives on the pedals, which parks that leg and the pelvis with it, and your hands and eyes both have a job. The seat works against you too. Most have a pan that slopes down toward the back and a backrest that is flat right where your waist needs filling, so the pelvis rolls backward and the low back rounds for the whole trip.
Then the part most people have never been told: vibration. A running vehicle sends a constant low-frequency shake up through the seat into your spine, and the muscles either side of it work continuously to damp it. Whole-body vibration is one of the better established occupational links to low back trouble, and professional drivers report more of it than office workers. You never feel that work happening, which is why the tiredness afterwards seems to come from nowhere.
Setting the seat up
Do this parked, and in this order.
- Sit all the way back. Hips in the crease of the seat, back against the backrest, no gap behind your waist. Perching forward hands your weight straight to your low back.
- Bring the seat close enough. Knees comfortably bent with your foot on the pedal, no stretching to reach, since reaching pulls you forward off the backrest and undoes the first step.
- Set the backrest closer to upright than you probably have it. Reclining well back feels relaxed, but it moves your head away from the head restraint and leaves you reaching for the wheel. Upright enough that your shoulders stay on the seat and your arms stay bent.
- Raise the seat until you can see easily over the wheel and the hood without lifting your chin. Sitting low means your neck makes up the difference.
- Fill the hollow at your belt line. Set the seat's lumbar adjustment so it just meets your back rather than pushing into it. If there is none, a rolled hand towel does the same job.
- Set the head restraint. The middle of it wants to be roughly level with the back of your head, and as close to your head as it comfortably sits. That is crash equipment, not a pillow, and down at neck level it cannot catch your head in a rear-end hit.
Take the wallet out of your back pocket
A thick wallet under one buttock tilts the pelvis for the entire drive, and every joint above it bends to compensate. It is a common cause of one-sided back pain in drivers, and the easiest fix here. Front pocket, door pocket, console.
Hands and arms
Keep your hands at about the nine and three positions or a little lower, elbows bent and resting rather than held out straight. Straight arms mean lifted shoulders, and an hour of that is the burning band across the top of the back.
Once you are moving
You cannot get up, but you are not stuck. Shift your weight from one hip to the other, roll your pelvis forward and back a little, move the foot that is not working the pedals, and drop your shoulders at every light.
On a long drive, stopping to walk beats every adjustment above. Two minutes out of the car every hour or so does more than any cushion. If your travel day is a flight and then a drive, back pain on long flights covers the hours before this one.
Driving on St. Thomas is its own load
Short distances here are not easy ones. The run up over the hills is steep grade, blind corners, potholes and near constant braking, so you brace and steer the whole way instead of settling into one position. Twenty minutes of that can leave a back sorer than an hour of straight highway does.
After a long drive
Walk before you sit down again. A few minutes around the car park, then unload, rather than making a bend and a lift your first move. Stiffness that eases as you move is normal.
When you should see someone else
Call 911 or go to the nearest emergency room for:
- Loss of bowel or bladder control, or trouble starting to urinate
- Numbness in the groin, inner thighs, or the area you sit on
- Leg weakness that keeps getting worse, such as a foot that drags
Leg pain with numbness or weakness that gets worse the longer you drive, and does not settle once you stop, needs an exam rather than a seat adjustment. When back pain is an emergency explains why the list above cannot wait. Sciatica covers leg pain generally.
Pain after a collision is its own case. Get it assessed even if it turns up a day or two later, which is common. See whiplash and car accident care.
Getting seen
If the seat is sorted, the wallet has moved, and the same drive still wrecks you, get it looked at. Dr. Keys is the Chair of the Virgin Islands Board of Chiropractic Examiners, a member of the Virgin Islands Chiropractic Society, and the International Chiropractors Association representative for the U.S. Virgin Islands. See lower back pain.
Call (340) 690-4994 to book. We take walk-ins and same-day appointments. Tradewinds Chiropractic & Wellness is in the VI Medical Foundation Building, Suite 202, 9150 Estate Thomas, St. Thomas, USVI 00802. Hours are Mon, Wed, Thu: 10:00 am to 1:00 pm and 3:00 pm to 7:00 pm. Tue, Fri: 7:00 am to 2:00 pm. Closed Sat and Sun. New patient forms are at forms.
Questions patients ask
How should I sit in a car to avoid back pain?
Sit all the way back so your hips are in the crease of the seat and your back is against the backrest, then bring the seat close enough that your knees stay bent without reaching for the pedals. Keep the backrest closer to upright than reclined, raise the seat until you can see out without craning, and fill the hollow at your belt line with the seat's lumbar adjustment or a rolled towel. Set the head restraint so its middle is level with the back of your head.
Why does my back hurt after a long drive?
Because you held one position you could not change, in a seat that rolls your pelvis backward and rounds your low back, while the vehicle vibrated the whole time. That vibration is the part people miss: the muscles alongside your spine work continuously to damp it, and you never feel them doing it. A driver also has one leg fixed on the pedals, so even the small shifts a passenger makes are off the table.
What is the best car seat position for lower back pain?
Upright rather than reclined, close enough to the pedals that your knees stay comfortably bent, high enough to see easily without stretching your neck, and with something filling the gap at your belt line. Sit fully back into the seat rather than perched forward. Any position needs to leave you in full control of the car and your head close to the head restraint, so reclining far back is not the answer even when it feels easier.
Can sitting on my wallet cause back pain?
Yes, and it is one of the most common avoidable causes in people who drive a lot. A thick wallet under one side tilts your pelvis for the whole drive, and everything above it has to bend to compensate. Move it to a front pocket or the console and give it two weeks before deciding whether it was the problem.
My back and neck hurt a day after a minor car accident. Should I get it checked?
Yes. Pain that starts a day or two after a collision is common rather than unusual, and it does not mean the injury is minor. Get it assessed rather than waiting to see whether it fades on its own.
