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. Never, never, never. 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. Nuff said.

• Better yet, avoid lifting. Ask a flight attendant for help. If you explain you have 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 do this for you.

• Ship ahead. This is my favorite solution for luggage – just mail your stuff on 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/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 – and wear it using both straps. The generally recommended maximum weight of a backpack is 10 – 15% of your body weight – less if you have a painful back. Using backpack has the added advantage of leaving your hands free to hold onto handrails on escalators, stairs, the boarding ramp, etc.

Proactively Manage the Airline Service

• 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 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 to 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.

• Preboard. When they call for pre-boarding for people who need assitance, that’s you. Make sure the gate agent knows you will need to pre-board. Conversely, if sitting for a moment longer than necessary will be unbearable, then board very last. If you do this, make sure your carryon can fit beneath your seat, because if you board last the overhead bins might already be full.

• 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 sticker to be able to park nearest the airport entrance.

• Avoid getting bumped. Due to overbooking, a practice that seems common lately, getting a seat assignment in advance can reduce the risk of getting ‘bumped’. If no seat assignment is given when you buy your airline tickets online, call the airline to get seat assignment immediately. If you arrive at the ticket counter without seat assignment on an overbooked flight, you probably will get bumped off the flight and 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, or a 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.

General advice

• Bring a letter. Get 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, if you need 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 keep your body nourished.

• 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 and 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, reducing stiff muscles, helping 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 good, comfortable supportive shoes if you will be walking distances through airports, train stations, etc. Slip on shoes are the best, because its easy to get them on and off (without having to bend over) when going through security.I also advocate diversion to help keep the pain at bay, especially if traveling will be stressful for you. One option is to treat yourself to something special – a great new book or 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.

Happy travels!