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What is spinal arthritis and how do we best manage it?

I recently was flying back from the gorgeous Coeur d'Alene, Washington area with many iron man participants that seemed in less pain than the pilot sitting next to me. He asked me a few questions about his lower back pain. Why does his back hurt in the morning? Why after sitting a few hours in his pilot seat does it make the pain worse? I started to explain how arthritis is a common thing that most people will have to manage through their life as they age and not to be scared if he hears this diagnosis from a doctor.


Arthritis is a normal wear and tear pattern which may have bee accelerated with injuries sustained along the way. It will start as inflammation at the joint level resulting in stiffness or what I call poor spinal articulation mobility. The arthritis can be both in the knuckle joints of the body otherwise called facet joints or in between the vertebral bodies where the discs live. Ohhh, no not the discs!


I explained how sitting and especially sitting passively in a slouched position for long periods is the most compressive position on the lower back joints. He stated, "Well that's my job, the seats are cheap at best, and I can only partially stand up in the front cabin so what can I do?" I gave him two concepts to think about, one ergonomic device to assist in posture, and how to apply them in his cabin.


1- Axial elongation: Big words for sit up tall actively against gravity so you can fight the degenerative compression forces. Don't rely on the terrible seats to do the sitting for you. It won't work. Sitting usually results in all lumbopelvic muscles to go on vacation and they may never come back if you don't train them. The best fix is to never allow them to go on vacation for so long. So when you catch yourself sitting slouched, correct it, sit tall as it looks more attractive anyway, and turn them back on to support your back.


2- Spinal articulation: Again, big foreign words just meaning to move this joints and better yet segment by segment. If it's the lower back pain you have then the pelvis dictates how the lower back joints move. Remember, earlier we talked about his pain increased after sitting in his air plane seat for long periods or in the morning after a few hours of sleeping.  What are we talking about? It is again less motion to those joints or possibly a poor position/posture of placing excessive stress and strain while your sitting or sleeping. There is an easy fix that I advised him to do often and routinely is to set his watch or phone on a timer for every 20-30 minutes and when it goes off tilt that pelvic forward and backward in a pain free range for about 1-2 minutes or until it feels better. If it makes the pain worse, stop and come talk to me for modifications as you may have a more difficult situation to maintenance.


Lastly; I don't think his job will buy sweet new airplane seats that support his lower back as it should be so; I advised a fairly cheap device to assist in positioning the pelvic in a less compressive posture for the lower back joints. It is called "Back joy" which is an ergonomic device that helps you tilt your pelvis forward to decrease the probability of slouching. This slouching thing is slowly accelerating you pain and further advancing your arthritis. Try it out and if it works great and if not no harm done. I left him with a phase that works with many dysfunctions which is "motion is lotion". Keep moving. Ask your Physical Therapists these questions on how to maintenance your body. You only have one body so take care of it.


Hope this helps guys,

Define Wellness and Physical Therapy

CC:

DH

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