When you have back pain, riding in the car for an hour or more can be a real challenge. Consider the following advice and see if it helps on your next road trip.

1. Get comfortable immediately

Take the time to make sure you're comfortable from the moment you set off on your trip. The smallest irritant in the beginning of your trip can turn into raging pain later.

  • Keep your back pockets empty. Sitting on your wallet, phone, or anything else may throw your spine out of alignment.
  • Sit up straight with your knees slightly higher than your hips, and keep your chin pulled in so that your head sits straight on top of your spine.

    See Posture to Straighten Your Back

  • Sit a comfortable distance from the steering wheel. For airbag safety, the National Highway Traffic Safety Administration advises sitting with your breastbone at least 10 inches from the steering wheel, 1 Air Bags. United States Department of Transportation, The National Highway Traffic Safety Administration Website. https://www.nhtsa.gov/equipment/air-bags. Accessed August 29, 2019. and keeping your hands on the wheel at 9 and 3 (the sides rather than the top of the wheel). 2 Using Efficient Steering Techniques. United States Department of Transportation, The National Highway Traffic Safety Administration Website. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/steeringtechniques.pdf. Accessed August 29, 2019. But don’t sit too far away either, which can cause you to reach too far for wheel and places more stress on the lumbar spine, neck, shoulder, and wrists.
  • Keep your back aligned against the back of your seat. To better support the contour of the inward curve in your lower back, use a small pillow or roll up a scarf and place it between your lower back and the seat. Also, there are many specialized cushions and pillows that can help with sciatica pain and lower back pain.

    See Types of Lumbar Support and Ergonomic Office Chairs

There is no single best option, and it may take some effort and trial and error on your part to find what works best for you.

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2. Make your ride as smooth as possible

Bumps in the road can jar your spine and increase pain. For a smoother ride, consider:

  • Riding in a passenger car, rather than an SUV or pickup
  • Replacing worn shocks to limit the bounce in the car
  • Replacing worn tires to reduce vibration or shaking
  • Sitting on a car seat pillow or coccyx cushion to provide more padding between you and the road

See Pain-Free Travel Tips

3. Get out and move around

Sitting in one position in a car will stiffen up your back muscles and can lead to achiness and possibly muscle spasm. Everyone should ideally take at least a 15-minute break for every 2 hours of driving. If you’re prone to back pain, you may want to take breaks more frequently, such as every 30 to 60 minutes.

Watch Video: What Is Your Back Muscle Spasm Telling You?

Try to plan ahead to schedule stops. Get out of the car so you can move around and stretch. Movement stimulates blood circulation, which brings nutrients and oxygen to your lower back.

Watch 4 Easy Stretches for Lower Back Pain Video

4. Shift your position periodically

When possible, try to move a little in your seat. Even 10 seconds of movement and stretching is better than sitting still. At a minimum adjust your seat and change your position slightly every 15 to 20 minutes. Pump your ankles to keep the blood flowing and provide a slight stretch in your hamstring muscles. Any movement that is safe to do in the car will help you out.

5. Try cold or heat therapy

Many people find that applying cold or heat therapy is a good way to alleviate pain on a long road trip.

  • Cold therapy can help reduce inflammation and swelling. Consider bringing a cooler to store reusable ice packs or other cold therapy packs. You can buy cold therapy packs at the store or make your own.
  • Heat therapy can help increase blood flow and relax the muscles. Various types of heat therapy are available to buy, such as heat wraps or heat pads. You can also make your own moist heat pack. Some people prefer to place a moist heat pack in the microwave so it’s warm when they go on the trip.

It is recommended to apply ice or heat for only 15 or 20 minutes at a time, then give your skin a rest to recover for at least a couple hours before the next application.

For drivers, it may be best to apply cold or heat therapy while taking a break from driving. Since you are unable to check the skin while driving, it is harder to ensure that the skin is not being damaged during an application of cold or heat therapy. Some cars have heated seats that provide continuous low-level heat, which can be a good option while driving if it is comfortable and provides relief.

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6. Support your back with your feet

Supporting your spine starts with bottom-up leverage from your feet. Your feet need to be placed on a firm surface and at the right height to avoid transferring stress to your lower back. It is ideal to have your knees at a right angle. This means, if your seat is too high it is best to put your feet on a footrest. If you are the driver and have the ability to use cruise control for a longer drive, you may want to do this to allow you to have both feet on the floor for periods of time.

See Good Posture Helps Reduce Back Pain

7. Employ diversions from pain

Having something planned to take your mind off the pain could make a big difference. Even if you're the driver, there are still a few options to safely help occupy your mind. Try a new music channel, download a podcast, or listen to an audio book.

Passengers have many additional choices, such as meditating, reading, watching a show, solving a sudoku or crossword puzzle, or playing an electronic game.

Bonus tip

If you know that long car rides give your back trouble, you may want to consider taking an over-the-counter NSAID (nonsteroidal anti-inflammatory drug) right before the trip to reduce the risk of back pain developing or worsening. Some examples of NSAIDs include aspirin, ibuprofen, and naproxen. Just remember to check with your doctor first and read warning labels carefully to reduce the risk of serious side effects or complications.

See Common NSAIDs for Back and Neck Pain

Try out these tips and see what works for you. Hopefully at least some of these tips help reduce your back pain while on the road.

Learn more:

9 Quick Back Pain Tips for Airplane Rides

  • 1 Air Bags. United States Department of Transportation, The National Highway Traffic Safety Administration Website. https://www.nhtsa.gov/equipment/air-bags. Accessed August 29, 2019.
  • 2 Using Efficient Steering Techniques. United States Department of Transportation, The National Highway Traffic Safety Administration Website. https://www.nhtsa.gov/sites/nhtsa.dot.gov/files/steeringtechniques.pdf. Accessed August 29, 2019.

Dr. David DeWitt is an orthopedic surgeon practicing at the NeuroSpine Center of Wisconsin, where he specializes in spine surgery. He has more than 15 years of experience evaluating and treating spine diseases and trauma.

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