Back and neck pain is serious occupational diseases which can result in a loss of productivity and even costly workers’ compensation claims. Truck driving, in particular, is an occupation that is prone to causing back and neck pain. However, there are some simple and inexpensive strategies transport managers can employ to ensure their drivers are not afflicted.
Truck driving, in particular, is prone to causing back pain, due to the inherent characteristics of the job, including strained postures for prolonged periods, sitting or standing for extended periods of time, exposure to vibration, and frequent lifting of heavy objects.
Many drivers will be familiar with lower back pain, upper back and neck pain, headaches, and fatigue, which are the result of a slumped sitting posture that rounds the back and shoulders, restricts proper diaphragmatic breathing, and forces the lower abdomen to protrude.
In 1975 already, Kelsey & Hardy (American Journal of Epidemiology, 102:63-73, 1975) found that the risk of developing a herniated lumbar disc is approximately twice as great for sitting while driving compared to prolonged sitting in an office chair. In addition, lower back pain is significantly related to time spent driving a car (Pietri et al., Scandinavian Journal of Work and Environmental Health, 18:52-58, 1992). The number of days absent from work due to lower back pain is six times higher for individuals driving more than 20 hours per week compared to individuals driving less than 10 hours per week, according to Porter & Gyi (Occupational Medicine, 52(1):4-12, 2002).
In a 2000 study of back pain among truck drivers, one hundred fifty-three truck drivers from a large chemical industry corporation were surveyed through questionnaires. An analysis of the results shows that the prevalence of lower back pain in one month was 50.3%. Interestingly, there was a higher correlation between the prevalence of lower back pain and drivers who reported that they experience a “shortage of time for spending with family".
With regard to occupational factors, the study revealed that working load and working environment showed no correlation with the prevalence of lower back pain, however, there was a significant correlation between lower back pain and "irregular duty time", "short resting time" and "long driving time in a day". Eighty-one of the 153 drivers surveyed (52.9%) pointed out the relationship between back pain and work that involves vibration or road shock.
The results from this and other studies suggest that vibration is an obvious risk factor for back pain. An improvement in working conditions reduces the incidence of drivers' back pain to some extent.
Truck drivers, more so than car drivers, must perform complex muscular movements in order to safely operate a vehicle. Driving tasks requiring musculoskeletal function include steering, braking, reversing, accelerating, and maneuvering the vehicle. Back and neck pain, as well as stiffness can to some degree impair a driver’s ability to perform these tasks as quickly and vigorously as is required to handle a truck. Individuals with lower back pain, in particular, have difficulty using a foot pedal. Of course, drivers suffering from severe pain and reduced mobility should not drive.
Slumping behind the wheel poses the greatest risk for back and neck pain. This incorrect posture is characterized by a collapsed trunk with a round back, round shoulders, and the head forward, while the relaxation of the lower abdominal and back muscles increases the stress to the back ligaments and discs. The pelvis is often forced forward on the car seat, away from the lower backrest. The resulting weight bearing on the seat from the tailbone amplifies the effects of road shock and vibration on the spine.
A slumped posture has serious implications for driver safety. Slumping reduces the driver’s ability to fully turn the head from side to side and as a result, the driver's field of vision is reduced. In addition, because it is difficult to bend the head backward when slumping, even a minor rear impact can result in whiplash. Driver fatigue is increased and driver alertness is affected, as the slumping posture prevents proper diaphragmatic breathing. The resulting shallow upper chest breathing increases fatigue and reduces alertness. If the driver adopts a correct posture, he will experience less pain and discomfort, which means driver distraction is also reduced.
In addition, to use the arms and legs to perform the driving motions, the truck muscles must be activated first. Slumping relaxes these muscles, so quick reactions are delayed, as the trunk muscles must first be activated. The correct posture will result in safer driving as the driver can react faster with the foot pedals and steering wheel if the trunk of his body is adequately supported by the correct posture.
Technology, fortunately, has created comforts such as power brakes, power steering, and automatic transmission, to help reduce the strain of driving. Adjustable height steering wheels enable drivers to find the correct posture to reduce strain on the neck and upper back, while adjustable armrests can reduce the strain of keeping the arms elevated to reach the steering wheel. Despite this, incorrect posture and sitting incorrectly for long periods, as well as the vibration and road shocks experienced, can negate these benefits.
There are some simple, inexpensive and effective ways to prevent back and neck pain while driving. Drivers should be trained to habitually follow the principles of good posture to ensure they are not afflicted by back and neck pain from hours of driving.
Some basic advice to help alleviate back pain starts with getting into the truck. Drivers should remove their wallets from their back pockets to avoid sitting at an angle. When getting into the truck, it is best to sit down first before swinging the legs in, one at a time. The same applies when getting out - move the seat back if necessary and the first swing out the legs, again one at a time.
The driver’s seat should be positioned the correct distance from the steering wheel. The hands should be placed in the right position on the steering wheel – just lower than shoulder level, left hand at 10 o’clock and right hand at 2 o’clock. The arms should be neither straight nor sharply bent, but rather comfortable and slightly bent at the elbows. To achieve this, it may be necessary to adjust the steering wheel hand position to, say 9 o’clock and 3 o’clock. The gear lever, indicators, wipers and other controls should be within comfortable reach. The mirrors must be adjusted so that the driver can see all around the truck without twisting his back.
The legs should be comfortably and correctly positioned, with the thighs level and the knees at the same level or higher than the hips. The knees should be bent comfortably, not squashed into a 90º angle. Pushing down the clutch increases pressure on the back, so ensure the pedals are within comfortable reach, with the heel resting on the floor and the rest of the foot on the pedal.
The backrest of the seat should be upright to support the curve of the back and should lean slightly backward to provide spinal support. A slight backrest inclination of about 10 degrees helps to stabilize the body with accelerating, braking, cornering, and other movements, as well as reduces the spinal stress from road shock and vibration, without interfering with the driver’s ability to maximize his field of vision. Wearing a seatbelt is not only compulsory by law but will also help to keep the spine straight and prevent slouching over the steering wheel.
Sitting in the correct position will go a long way to alleviate back pain, but extended journeys will still have an effect on the spine. Drivers should do a few gentle warm up exercises before getting into the truck and should stop regularly on long journeys to stretch, walk around, turn their heads from side to side and roll their shoulders up and back several times.
Drivers should also avoid twisting the spine by reaching back from the front seat to get something behind the seat. The long periods of exposure to vibration tire the lower back muscles. As a result, drivers should avoid lifting heavy objects right after a long journey to reduce the risk of lower back pain.
Drivers can also use a lumbar support, small pillow, lumbar roll or wedge for additional lower back support and to encourage good posture during long periods of driving. Many of these supports fit onto the existing truck seat. Such a support should have a firm seat bottom to prevent the driver from slumping, which puts severe pressure on the lumbar spine. The driver’s hips should be firmly pressed to the seat's backrest, so the spine is held in a natural upright position, relieving lumbar pressure. A support made of woven fabric will also help prevent the pelvis from sliding forward on the seat.
Considering the amount of time truck drivers spend in their trucks every day, the cumulative benefits of adopting these good habits will go a long way over the years to ensure minimal back strain while driving.