Making Your Drive Less of a Back Pain

Some car shoppers take along their mechanically inclined mates. Others seek help from a friend who knows how to negotiate a bargain. Then there’s Tamar Cooper of West Los Angeles, who asked her occupational therapist to accompany her when she headed out to buy a car.

With a history of back pain, Cooper wanted to be sure she was picking a vehicle that would minimize her discomfort. So as Cooper sat in various models, Kathy Warner, an occupational therapist at the Arthritis & Back Pain Center of the Swezey Institute, observed and evaluated the built-in lumbar support of the seat as well as the supplementary seat Cooper uses.

“I had decided on a Camry,” Cooper says. “But when I took a test drive, I had back pain.” After stops at Ford and Jeep dealerships, she shopped at a Buick dealership and settled on a LeSabre. Before buying it, she rented one for a day. “It was great to get in and out of,” she recalls. And, most important, it was easy on the back.

Back support might not be high on your wish list as you car-shop. But once you’re sitting in traffic--especially in Los Angeles, where the average weekday round-trip commute is now 69 minutes--it’s painfully clear that a back-friendly car can mean the difference between a miserable commute and a tolerable one. And if you don’t have back pain now, it might be around the corner. Back pain is the reason given for about 14 million doctor visits a year in the United States, the National Center for Health Statistics reports.

To find the best car for your back, specialists advise that you carefully evaluate the seat’s built-in lumbar support--that part of the seat that makes contact with the lower back--and its adjustability as well as the overall smoothness of the ride.

If the lumbar support and the ride fall short (or if your present car doesn’t measure up and you’re not in the market to buy), consider special pillows and supplementary seats that can make the ride easier on the spine. Special exercises, done in and out of the car, also can help protect your back.

Finding the Best Support: Today, many car models have adequate lumbar support built into the seat, says Dr. Robert L. Swezey, a rheumatologist and physiatrist who is medical director of the Swezey Institute in Santa Monica and specializes in nonsurgical treatment of back problems. But some models, he says, are definitely better than others.

Some vehicles, for example, have a bladder-like pillow inside the lower part of the seat back that can be inflated as little or as much as necessary to support the lower back. In other models, the driver adjusts the seat by moving it to improve support to the lower back.

Most often mentioned as having good built-in lumbar support by Swezey and other back specialists are Lexus, Acura, Mercedes-Benz, Volvo, Saab and Saturn.

In general, the best lumbar supports are found in the most expensive models, says Warner, the occupational therapist.

The worst lumbar support? Based on anecdotes from back pain patients, older-model Cadillacs and low-slung sports cars are the worst, seeming to give too little support to the lower back area, says Dr. James V. Luck Jr., president, chief executive and medical director of Orthopaedic Hospital in Los Angeles.

(But the 1998 Cadillac Seville STS offers as optional equipment its adaptive seating system, which features a network of air cells in the seat cushion and seat back to provide support, storing in a memory chip the ideal support measurements for each driver.)

In general, bucket seats are harder on the back than bench seats.

Besides a seat with good lumbar support, other car features can help minimize back pain. Look for wide-angle mirrors, which minimize the amount of twisting and turning required while driving, Swezey says. Make use of an adjustable steering wheel, which can be positioned so you can drive without placing undue stress on the back. Consider cloth seats if leather seats are so slippery that it’s difficult to maintain stable posture while driving. (But for drivers who have difficulty getting in and out of the car, leather may be better, Swezey says.)

Taking the Test Drive: When test-driving, pay attention to how much the car vibrates, Swezey advises.

“Disks are susceptible to vibration, and it apparently makes them more vulnerable,” he says. “If a car’s shocks are good, there is less vibration.”

Says Luck: “If a car bounces, it’s harder on the back.”

Sit in a way that you maintain an arch in your back, he says. Be sure there is enough headroom so you can sit upright without slouching, which is also stressful to the back.

The headrest should be positioned so your head makes contact with the center and is protected if it is thrown backward during a sudden stop.

Supplementing the Support: If your car has inadequate lumbar support, consider special supplemental seats or pillows to protect your back. Frequently recommended by back specialists is the Sacro-Ease, a seat that is custom fitted to support the small of your back as you sit in the car. Depending on models, the Sacro-Ease retails for about $115 to $190. (For information on availability, call Relax the Back stores, [800] 290-2225, or McCarty’s, the manufacturer, [800] 635-3557).

Or if your car seat is reasonably supportive, Swezey says, you might consider the beaded-type seat favored by taxi drivers for additional support.

Less expensive than the Sacro-Ease are portable pillows, available at specialty or medical supply stores for about $30. Some self-inflate to provide exactly as much support as needed.

Stretching and Exercising: Back specialists suggest taking frequent breaks from driving, if possible, to minimize back pain. Developing a habit of exercises to protect the back is also recommended.

Specialists advise that you check with your doctor or physical therapist for exercises geared to your specific back problem. Illustrated back exercises are also available from the American Academy of Orthopaedic Surgeons, (847) 823-7186, and on the World Wide Web at https://www.aaos.org. Swezey has produced an audiotape, “Drive Away Back Pain” ($16.99), that includes an explanation of in-the-car and out-of-the-car exercises. To order, call (800) 860-3949.

Times contributor Kathleen Doheny can be reached via e-mail at kdoheny@compuserve.com.