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Lower Back Pain: A Curse for the Professional Pilot

Most occupations come with their own occupational health issues. Voice strain for the teachers and public speakers, carpal tunnel syndrome (CTS) (pain and numbness in the fingers) for the IT programmers, deafness for factory workers, just to name a few.

Does a pass from the biannual medical examination mean that there are zero health issues for pilots? Unfortunately, the answer is no. Low back pain (LBP) for example is one of the issues that troubles many pilots.

Low back pain is a symptom of pain, soreness or stiffness felt in the back, but it can also extend to upper legs, shoulder and neck.

Many people from other walks of life also experience low back pain, but for the pilots, it really does come with certain aspects of the job. This includes long hours in the cockpit, ineffective lumbar support and seat padding, poor posture, the vibrations during the flight, forces exerted on the back during take-offs and landings as the plane is at an angle, stretching the body to reach the controls and switches while remaining strapped into a fixed seat.

People should take LBP seriously, a pilot experiencing a painful distraction while controlling an aircraft could compromise flight safety. Early intervention is vital, if LBP is persistent after 3 months, it will become chronic LBP which will make it much harder to treat.

Prevention is better than cure. There are a few things you can do to help alleviate the pain after flights

[endif]Exercise, especially the ones which involve stretching the muscles, like Yoga, Pilates and Aerobic exercises. Focus on the flexibility exercises, these will not only stretch and relax the hardened muscles, they will strengthen the muscles to prevent LBP

  • Be cautious when lifting heavy objects which include your flight bags, always try to keep the spine in a vertical position and use the power of the legs rather than the back. This helps to prevent back injuries

  • Check if you require supplementary seat cushion for the flight to give your back enough support and try to keep the back straight when sitting down

  • Use a firm mattress at home. This helps to give support to the back while at sleep

  • If you are already experiencing the pain and it does not seem to go away, the following therapies might help

  • Chiropractic / Osteopathy / Physiotherapy. These all involve applying forces to muscles, bones and joints around the spine to release the pain. You will need to find a qualified practitioner and do check their credentials first.

  • Acupuncture. This involves inserting fine needles at certain points,

Cupping therapy. Cupping involves heating the inside of the cup before placing it onto the back, the vacuum inside the cup will create a suction in the areas which causes the skin to rise and redden as the blood vessels expand. There have been many debates on why acupuncture and cupping would work. Dr. Li from Civil Aviation General Hospital in Beijing, China explained our queries.

Michael Phelps. His cupping marks clearly visible.

“There have been many misunderstanding as to why and how these traditional Chinese therapies work. Our Chinese pilots grew up to see their parents and grandparents use these therapies, so it is natural for them to use these on a regular basis and they have kept them as their preferred treatments as they do work if you use the qualified practitioners. To relieve back pain, acupuncture and cupping therapy work in a similar fashion, both are there to stimulate the body to increase the blood circulation.

“Acupuncture’s fine needles work at certain points, but as they are inside the body, they will cause the body to react to this ‘invasion’ by dilating the blood vessels and circulating the blood quicker to ‘expel the invaders by trying to squeeze them out’, the increase in the blood circulation in turn will increase the oxygen flow, remove the built up lactic acid and other wastes and also provide more nutrient disbursement for the muscles. These all help to reduce discomfort in the muscles and soften the muscles. Cupping works in a similar way, but even though the cups are on the surface of the skin, they work on a wider area rather than just a point, the vacuum suction will suck the blood out from the blood vessels locally, that is why you see these red/purple marks, but these generally disappear after a few days and will not leave any scars or marks. By lifting the ‘old blood’ out to the surface of the skin, the ‘new blood’ will have to fill its place, this is how it stimulates the body to increase the blood circulation. This again will increase the oxygen flow, remove the waste and provide more nutrient to the muscle to relieve the pain.”

Cupping therapy surged after people found out that Michael Phelps and other Olympians used this on a regular basis for their preparation of 2016 Rio Olympics. This is not surprising as it has been practiced over 2000 years in China. If it did not work, the practice would have disappeared many years ago. As Dr. Li said, “ It is important that you find a qualified practitioner and check their credentials first before using them. When they are applied correctly, they would be immensely beneficial for not only for pilots, but many other occupations like office workers too.” We thank Dr. Li for her input for this article.

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