When Luggage Becomes a Pain in the Back

Whenever Annette Swezey took a trip, she would wait until the last minute to pack, stuffing clothes and other necessities into a suitcase flung open on the bed. She would reach into her closet and then bend over the suitcase, again and again, into the wee hours.

Just as inevitable as her 11th hour pack-a-thon was the back pain that struck at the start of each trip. “I was beginning to think it was psychological,” she said. Then Swezey, a health educator, and her husband, back specialist Dr. Robert Swezey, stepped back and looked at the big picture. Packing mechanics--or rather the lack of them--were to blame.

So they made proper packing techniques a topic covered on educational tours of the model motel bedroom and bath in the Arthritis & Back Pain Center at the Swezey Institute in Santa Monica.

During a 45-minute tour, travelers with back problems are taught how to hang clothes in a closet without hurting their backs, how to lift suitcases easily and how to endure long airplane or train trips. They also learn the best first-aid techniques for backs that give out despite such preventive measures.

“Travel is a real troublemaker for people who have had back problems in the past,” said Robert Swezey, a UCLA clinical professor of medicine. Dr. Ian Armstrong, chief of neurosurgery at Century City Hospital, agrees. He receives many calls from patients complaining of back pain, both after a trip and even long distance during travel.

Protecting the back should begin, Robert Swezey tells patients, when travelers call for reservations. When booking a hotel, request a room with a firm mattress. And if traveling by air, ask for an aisle seat, preferably one near an exit, or for a bulkhead seat to maximize legroom, which can help to ease pressure on the back.

During a long trip by train, bus or air, occasionally walk around and stretch. “Get up every hour on a long flight, even if you have no discomfort,” Armstrong tells patients.

If traveling by auto, adjust the seat so that knees are level with hips, Armstrong said. Sit closer to the steering wheel so that arms are bent at your sides.

When packing, kneel down if the suitcase is at bed level, but it is easier on the back to pack a suitcase that is at card table or bureau height, Annette Swezey said, since that position minimizes bending. Pack two lighter suitcases rather than one heavy one to create more equal distribution of weight for carrying. Consider taking a lightweight luggage dolly. Robert Swezey recommends this over a suitcase with wheels, which he finds can jam and lurch. If airport luggage carts are available, use them.

Once at the hotel or motel, avoid using fold-out luggage holders that usually require bending to unpack and pack. Before hanging clothes in a closet, remember the phrase “Feet first and face it,” the Swezeys tell travelers. That stance will reduce twisting of the spine, which can lead to injury.

Ask the front desk for extra pillows and use one or two between or under the knees to increase comfort.

Take along a cold pack in case back pain strikes. A portable, fold-up footstool can also make long rides more comfortable.

In the hotel bathroom, place toiletry articles up high to decrease the number of times it is necessary to bend over.

Despite best efforts, some travelers still experience back pain. For immediate first aid, Robert Swezey advised: lie down as soon as possible, ice the painful area and rest it.

“Limit activity and take anti-inflammatories like Motrin and Advil,” Armstrong said. “During the acute phase of the injury, ice is best because it reduces swelling.” Once pain has subsided, heat can be applied to increase blood flow to the area and further reduce pain, he said.

The Healthy Traveler appears the second and fourth week of every month.