Watch your back

| April 30, 2009

Lower back pain accounts for up to a quarter of all workplace injuries, according to a 2008 study by the University of Iowa Carver College of Medicine. Truckers get more than their fair share of that due to the nature of their work and the associated lifestyle.

As many as three-fourths of the nation’s professional drivers suffer from lower back pain, says Dr. Eric Wood, occupational medicine director at the University of Utah. Wood researched trucking’s medical hazards through a 2006 Federal Motor Carriers Safety Administration fellowship, and continues that research through the Rocky Mountain Center for Occupational Medicine.

“The only truck drivers I know who don’t have back problems are the ones who just started and are in their 20s and 30s,” says Karen Syverson, a Huntsville, Ala., resident and driver for C&W Trucking. She says older truckers may be more susceptible to back pain partly because of years spent operating older trucks with seats and steering wheels of poor ergonomic design.

Syverson considers herself in pretty good shape for her age, 62, but still feels the occasional pangs of lower back pain. “I try to stretch it out, both in the morning before I start and after I’m finished at night,” she says.

Dr. John McElligott, chief medical officer for Professional Drivers Medical Depots, says that the physical aspects of trucking amount to “a back problem waiting to happen.” McElligott says that long periods of sitting followed by brief but intense periods of manual labor put the back muscles at risk for tension and strain.

Wood explains that such situations are worse because truckers often don’t give the muscles a chance to adjust from being at rest to being active. “If you were going to participate in a sport event with high physical activity, you’d warm up first,” Wood says.

The University of Iowa study reports heavy or repetitive lifting or overhead reaching, sustained bending and twisting of the trunk, and standing or sitting for long periods causes back problems. Obesity and poor conditioning, common among truckers, also contribute to stress on the spine.

Those conditions are difficult to fight. “Drivers are faced with physical barriers to gym access and time constraints,” says Melodie Gill, a nurse practitioner with Celadon Trucking. She adds that drivers also have little choice for ordering nutritiously balanced, lower-calorie meals at truck stops and fast-food restaurants. Even smoking, because it decreases blood circulation, contributes to lower back pain.

One suspected cause of back pain is unique to the transportation industry: whole body vibration. Parts of the body resonate, or vibrate, at specific frequencies. Because engine vibration is at odds with the body’s natural frequencies, muscles tighten to dampen the vibration, resulting in increased strain over time.

A 1997 study by the National Institute of Occupational Safety and Health reported strong evidence tying whole body vibration to lower back pain, though Wood notes that improvements in truck suspension and seating may have decreased the problem since the study was done.

Bobby Garlin, a driver for Rosedale Transport Inc., says that even in a new truck, such as his 2009 Volvo, driving is hard on the back. “You take any truck out here, Peterbilt, Kenworth, Volvo, and ask any driver – they’re going to tell you the same thing. The roads are so rough they literally beat the hell out of you,” he says.

Garlin, a Cohutta, Ga., resident, says that potholes and bridge connections on interstates are even more bothersome. “When you hit a 2- or 3-in.drop or pickup, you’re going to feel it,” he says. “It’s like hitting a speed bump at 45 miles an hour.”

Prevention
“Nutrition and exercise are the core of preventing back pain,” Gill says. She advises drivers in Celadon’s wellness program to develop healthy eating habits and find exercise plans that fit their lifestyles. “For instance, 32 laps walking around the tractor trailer equals approximately one mile,” she says. Cardiovascular exercise such as walking increases circulation and helps strained muscles by delivering nutrients and proteins necessary for healing.

The other key practice is stretching muscles before vigorous activity. “When a truck driver is in a static position for a period of time, certain muscle groups start to tighten up, shorten up and get tension,” says Tom Garger, an exercise therapist and ergonomic consultant with Ergoflex consulting. Woods says stretching is the best way to prepare the muscles of the back, shoulders and legs for loading or unloading a trailer.

Garger says that stretching the hamstrings, hip flexors, neck, chest and shoulders is important to prevent or alleviate back pain. He warns against the common problem of over-stretching.

“Start the stretch easier and hold it longer,” he says. “It should never be painful or uncomfortable.”

Treatment
When back pain escalates into a chronic condition, it can be treated with medication, physical therapy or, in some cases, surgery.

Most episodes of lower back pain are due to muscular strain and are usually resolved with time and the introduction of on-the-job preventive measures. Celadon drivers who visit the company’s clinic for back pain treatment are sometimes referred to a physical therapist, Gill says. The therapist often prescribes stretching and abdominal strengthening exercises. Anti-inflammatory drugs, both over-the-counter and prescription, are commonly used in treatment.

McElligott says his clinics avoid recommending surgery because it’s costly and has only about a 50 percent success rate. “Surgery can make the problem worse or better,” he says. Also, the recovery period can keep a driver off the road for an extended period.

Instead, McElligott sometimes prescribes transcutaneous electronic nerve stimulation. The therapy “makes the muscle contract and relax,” he says. His clinic advises truckers to “use it while they’re driving so that the muscles are constantly stimulated.” A TENS unit is typically battery-operated and uses one to four electrodes.

However, certain symptoms in conjunction with back pain can indicate a more serious problem, such as an infection, a herniated disk or a tumor. These symptoms include bowel or bladder problems, a drag or weakness in a leg, unremitting pain or fever.

Left untreated, certain spinal problems progress to narrow the spinal column, resulting in more pain and less flexibility. Don’t hesitate to get a doctor’s diagnosis if you suspect a serious problem.

Lower back stretches
These and other stretches that focus on the back, legs or neck can be performed in the cab or just outside your truck. Hold each stretch for 30 to 45 seconds, relax and repeat five to 10 times.

While seated, place one ankle on opposite knee. With a straight back, gently pull knee toward chest.

With arm extended and palm forward, grasp truck handle. Gently rotate body away from truck.

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