Tips For Decreasing Spinal Pain While Driving
TIPS FOR DEFEATING NECK AND BACK PAIN WHILE DRIVING
Steve Daisey MPT, CSCS

Adjusting Your Car Seat
Protecting your back while driving involves an interplay between your body's posture and the adjustments of your car seat. My recommendation is to adjust your posture and seat in a manner that places you in optimal posture - maintaining the normal curves of your spine.

HOWEVER, know that you will be slightly changing your posture with little movements and exercises throughout the drive. This ensures that your spine continues to move, which is crucial to maintaining health of the spine.

1. First, be sure you are not sitting on anything that could throw your alignment off (such as a wallet).

2. Adjust the seat forward/backward to a point where you are comfortable. Your feet should easily touch the pedals. You should be at a distance from the steering wheel that is comfortable for your arms. You should have easy access to all controls. This is important, since excessive reaching can place more stress on the spine.

3. Next, if possible, adjust the seat up and down so that it meets your thigh a few inches from the knee. Your knees can be either slightly higher than or level with your hips. You will likely read advice recommending one or the other. You will have to determine what your preference is for your spine. If you are unable to adjust your seat in this manner, you may have to purchase a wedge, or use towels to raise the seat.

4. Now sit upright, with your back aligned straight, looking ahead through the windshield. Sit in a manner that maintains your normal spinal curves (slightly arched back, shoulders back, head/neck straight).

Now, readjust the back of the seat to meet your spine at this position. The seat will likely be around 95 to 100 degrees (see picture below).

More than that will force the lower back to slump and the shoulders and head to come too far forward.

5. To determine if you have optimal headroom, you should be able to get a fist (thumb pointed down onto the crown of your head) between the ceiling and your head.

6. Your head should hit the headrest at the level of your eyes. If the rest is too low, this can result in more trauma to the neck during an accident. You should be able to easily rest your head on the headrest without tilting your head back.

7. Finally, adjust the lumbar support if possible to help place your spine in a slightly arched or lordotic position. If this is not available on your seat, use a towel-roll to build the lumbar support. Most automobile seats are already constructed with a lumbar support built in. Often the support is either too high or too low. If the lumbar support is not adjustable, a towel roll will come in handy.

Note that the head can easily rest back on the headrest, and the angle of the seat is helping to maintain the normal lower back curve.

Exercises and Movements to Decrease Strain
No posture is good posture if maintained for too long (greater than 10-30 minutes, depending on the individual). Therefore, it is important to move often while you are driving, but in a way that is not distracting.

Here are some suggestions for how to move while sitting and driving:

Pelvic Tilt
Roll your pelvis forward to increase the arch in your lower back (you will feel like you are sticking your upper chest outward) and then roll back to neutral. This exercise helps move and loosen the lower back, and allow the discs in your lower back to be nourished with fluid.

Side Pelvic Tilt
Shift all of your weight over to the right hip and pick up the left buttock slightly off the seat. You will feel your left shoulder and left hip come closer to together. Switch and repeat with shifting the weight over to the left hip. This exercise also helps feed the discs in your lower back.

Gluteal Squeezes
Pinch and squeeze the buttock muscles together. Hold for 10 seconds and then relax. This exercise will help use the stronger gluteals as a postural muscle, allowing your lower back muscles to rest.

Shoulder Pinches
Squeeze your shoulder blades together and hold for 2-3 seconds. This will help keep your neck muscles from tensing up and work for the neck in the way gluteal squeezes work for the lower back.

Head Nod and Neck Rotations
Head nod as if you are saying "yes ma'am." Neck rotations would be like saying "no ma'am." Do this for 20 seconds. This will help warm-up the muscles at the base of the skull where headaches often begin.

Whichever movement or exercise you choose to perform or make up, what is most important is that you shift in some way, often enough to keep your spine from getting stiff.

References:
1. Porter JM, Gyi DE. The prevalence of musculoskeletal troubles among car drivers. Occup Med (Lond) 2002 Feb;52(1):4-12.