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Question for the medical community--Sciatica and pilots.

pierre smith

Well Known Member
Mornin' all...pincushion here:mad:

After enduring a three-needle epidural and steroid injection, multiple bodily punctures yesterday, I wondered whether pilots have a greater number/ratio of men/women with sciatica than non-pilots.

I've endured 45 years and around 20,000 hours of flying, mostly ag and have been hammered by extremely rough air, every year...the worst hammering being in my RV's...because of their speed/low wing loading.

Does this beating have a long term effect on whether or not your chances of developing sciatic nerve/leg pain problems are greater than non-pilots, or could it be...in the words of Jimmy Buffett..."Yeah, it could be my fault"....for being 66:)

Thanks,
 
sciatica

Yes Pierre...It.s all your fault!...You.ve got a body!...and it.s been lived in!!..I.m the same ..65....45 yrs flying...26000hrs.... ...sometimes everything hurts!..Rgds!.. stanman......RV8 ...Certification mode!!!...finally....
 
Only about 6000 hrs here, so I havent as an "experienced" backside! :) While not a direct answer to your question, I have had back problems since the age of thirty from a herniated disk. Sciatica was one symptom. Or so I thought.

A new doctor I went to a couple of years ago had me remove my wallet from my back pocket and stop sitting on it. Since then my sciatica has disappeared. Still have problems with the disc, serious ones sometimes, but the sciatica is gone. And, no, the wallet was not that fat!

So, I'm sure your occupation adds to the problem considering the pounding your backside takes(!) (most of mine was commuters), but if your wallet is in your back pocket, it might be adding to the problem.

Something else that seems to help is I swim laps for exercise, and have noticed if I neglect it for too long, my back lets me know it!
 
Aging and abuse the back ...

I had it five years ago. My doctor told me that it was caused by spinal disc herniation (one of the most common cause). At the time I was finishing my RV9A. It was painful even to get in and out of cars. I had to roll slowly onto the bed and reverse the process to get off. Fortunately, my wife learned in a medical conference that Glucosamine/Chondroitin works for many patients (U of Michigan did a study and showed that it is one of the few suppliments actually works). After a little more than one month and before my first flight I was cured. I have been taking glucosamine/chondroitin everyday and have not had any disc problem (thus, sciatica). Our senior citizen cat just began taking glucosamine and she is moving around much better.
 
Thanks Damon

I haven't owned a wallet for more than thirty years....found out real quick from sitting in Agwagons for 70 hours a week! I have my cash wrapped around my credit cards and licenses in my front pants pocket....good advice.

I do Glucosamine daily...thanks....also drink OJ or grapefruit juice every morning for my 'C' fix, plus a glass of V-8..vrooom:)

Best,
 
As with all things medical, Pierre, we're all different. I'm no back guy, but I did suffer from some sciatica a few years ago. Came out of nowhere. Couldn't think of any specific trauma that I'd encountered.

Went to a chiropractor and he confirmed my diagnosis and cracked me around a bit. A few weeks later I was really no better. It wasn't debilitating, but very annoying.

Within a year, we stopped driving from IN to NJ to see kids because they were all grown and off to college. The pain gradually stopped.

I finally concluded that the symptoms were caused by sitting in one position for hours at a time without moving my legs around, especially when stuck in traffic and I couldn't use the cruise control.

Consequently, when I fly now, I'm always shifting a bit in the seat, stretching out my legs. When I forget to do that, I'm well aware of my neglect when it comes time to land!

So, try moving around when you fly and avoid sitting in one position for long periods. If that doesn't help, then you're probably right -- YOU'RE JUST OLD. :D
 
GREAT QUESTION!!

and one that is certainly timely to me Pierre. I had a 2 year job assingnment in Fort Stockton, TX which is exactly 407 statute miles from my home. It was a 6 hour drive or 2 hours in the -4. I didn't have any back/leg problems for the first 6 months.

FST has a 7,500' runway I'd do my walking on. One day I got to the end & almost had to crawl back. There is another thread here about -4 seat cushions. I switched to Oregon Aero (even got an OA cushion for car) and it really helped me. The -4 being more comfortable than the auto of course.

Point is, I believe you are on to something. Sitting extended periods is just not good for a person.

I have just started doing these exercises found at this site: http://www.spine-health.com/wellness/exercise/exercise-sciatica-spinal-stenosis

I am going to Doc next week to get started on checkout. My pain manifests itself in my right leg. I'm certain it is nerve related as the pain can run anywhere from ankle to hip.

Message for all you youngsters flying RVs now & are bewildered by this conversation. Take Heed. Think about your health & comfort now. It is just like ear protection for your hearing. Our actions have cumulative effects.

Good Luck to all---unfortunately, I FEEL YOUR PAIN!!:(
 
Physical therapist here. Short answer, Pierre: Yes, your flying could easily be at least part of the cause of your symptoms. When it comes to degenerative change (degenerative disc disease, "arthritic" changes like spondylosis, etc) the research tells us that genetics and time (i.e you ain't 18 any more) play a much greater roll than activity/career etc, but acute disc bulges and herniations are a different story. They are very much influenced by prolonged postures, and sitting is one that puts very high stress on the posterior (back) aspect of the disc. When you sit, your low back loses its normal slight backward curve (the lordosis), so the front of the disc is squished somewhat, resulting in the disc contents being squeezed backward. The stress on each low back disc in sitting is roughly 1.5g at rest. The result is that eventually the rear of the disc starts to bulge and then to gradually fail from the inside out, until it really bulges or herniates. Result: pressure on the nerve roots and "sciatica". Couple that with increased stress from g's and from turbulence, and the effect is multiplied. Plus you're a tall guy like me; put yourself in an RV where your butt is low, back is fairly straight up and down, and knees are much higher than your hips, and your back is pulled even more into flexion (forward bend) which makes the stress on the low back even worse.

So what to do? First thing is to position yourself as well as possible; in a plane like the RV that means keeping your seatback reclined as far as you can to decrease the lumbar flexion, and to make sure your low back is supported in as close to it's neutral (slight backward curve) position as possible, using back cushions with good lumbar support or even something as simple as a rolled up towel. Also, when you can in flight, stretch your legs out to get your knees as low as possible relative to your hips; this reduces the pull into flexion and allows your back to go back toward it's normal, lower stress neutral position as well.

In the meantime, hope your recovery from this episode goes well; best thing is to keep moving doing as much of your normal routine as you can, try not to sit for too long at a time, walk lots, etc. Good luck!
 
Good Info...

Physical therapist here. Short answer, Pierre: Yes, your flying could easily be at least part of the cause of your symptoms. When it comes to degenerative change (degenerative disc disease, "arthritic" changes like spondylosis, etc) the research tells us that genetics and time (i.e you ain't 18 any more) play a much greater roll than activity/career etc, but acute disc bulges and herniations are a different story. They are very much influenced by prolonged postures, and sitting is one that puts very high stress on the posterior (back) aspect of the disc. When you sit, your low back loses its normal slight backward curve (the lordosis), so the front of the disc is squished somewhat, resulting in the disc contents being squeezed backward. The stress on each low back disc in sitting is roughly 1.5g at rest. The result is that eventually the rear of the disc starts to bulge and then to gradually fail from the inside out, until it really bulges or herniates. Result: pressure on the nerve roots and "sciatica". Couple that with increased stress from g's and from turbulence, and the effect is multiplied. Plus you're a tall guy like me; put yourself in an RV where your butt is low, back is fairly straight up and down, and knees are much higher than your hips, and your back is pulled even more into flexion (forward bend) which makes the stress on the low back even worse.

So what to do? First thing is to position yourself as well as possible; in a plane like the RV that means keeping your seatback reclined as far as you can to decrease the lumbar flexion, and to make sure your low back is supported in as close to it's neutral (slight backward curve) position as possible, using back cushions with good lumbar support or even something as simple as a rolled up towel. Also, when you can in flight, stretch your legs out to get your knees as low as possible relative to your hips; this reduces the pull into flexion and allows your back to go back toward it's normal, lower stress neutral position as well.

In the meantime, hope your recovery from this episode goes well; best thing is to keep moving doing as much of your normal routine as you can, try not to sit for too long at a time, walk lots, etc. Good luck!

Thanks Gerry, I'm going to practice that. I note having an autopilot is a great assist for stretching the legs some now. Allows for more shifting & movement. I have extended range tanks; but I'm figuring on more frequent stops in my future now.

Thanks again,
 
Good advice

Yep, it started last year, driving my wife's Honda Pilot for three hours to the coast. I told her the seats were lousy.

Then, I flew my -10 to Camp LeJeune to take my stepson to Marine school, sitting for nearly two hours each way, and I said, "These -10 seats are lousy."

Everything I sat in was lousy until I heard Jimmy Buffett singing.."it could be my fault." I'd even called Oregon Aero, makers of my Tempur foam seats and he was surprised that I was complaining and told me that those are as good as one can buy..."Heck, we make seats for the military even!"

So take Deal's advice and don't scrimp on your seats, all you young guys...older guys too!

Yep...it sure was my fault:)

Best,
 
Thanks Gerry.

Quote: 'In the meantime, hope your recovery from this episode goes well; best thing is to keep moving doing as much of your normal routine as you can, try not to sit for too long at a time, walk lots, etc. Good luck!'
__________________
Gerry Julian

Great advice...and BTW, my physical therapist said that it took her 7 years to become certified..only 1 year less than an M.D....so their advice is very sound.

Thanks again,
 
Ditto

what Gerry said. As a PT, we see this all the time. There are some simple stretches you can do that will help. Just google sciatica and you will find them just beware you will also find contrasting info on the same scale of the primer wars.
 
I too have a serious back problem that is being dealt with as I write this post. I am currently researching the cushions that RV-4 builders use but I am also looking at what is installed in the rest of the RV flying fleet worldwide. Here is the thread I started over in the RV-4 forum:

RV-4 Seat Cushions and Upholstery

Feel free to add your comments to the thread I started.

Pierre, I hope your back problem clears up soon mate.
 
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Good Advise

Thats good advice from Gerry!!

I have two crushed discs, my doctor thinks from falling off motorbikes???

The result is that if I twist the wrong way, or sit in a too inclined position I am in extreme pain and sometimes cannot stand and walk. The last bad episode I had was about 6 years ago just before I retired from the police..... agony!! I had to cancel a scuba diving holiday and it took almost 2 months to get back to normal.

I sold my share in the Tailwind because the seating was too inclined and gave me back ache. I have to put an extra lumbar support cushion in the 9 even though it is a more reclined position to sit in.

The other thing you can do is build up your stomach muscles which support the spine. I do 400 a day on large exercise ball. Started with 20 and gradually built it up! The result of sitting in a position which suits my injury and the exercise is no significant back pain for 6 years.
 
Pierre, take a look at the link below.

This is something a very close friend of mine has invented, it is a spin off from his work with wheelchair bound patients.

I have a couple of these, for my truck, and they are fantastic.

There is a model specifically for aircraft also. I suspect they will help with your long hours in the spray plane. Even the Air Force is looking at them for fighter pilots.

Give them a call, ask for Rex, and tell him I sent you.

Next time you visit Paradise, stop in and see them.

http://www.thebestseatever.com/index.html
 
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As you may have surmised from the previous posts, there are multiple causes of sciatica and treatment depends on the specific cause. Anything that presses on the sciatic nerve from its origin at the spine, or along its course through the butt and down the leg can trigger sciatica. If butt or leg pain is associated with pain or tenderness in the mid-line of your lower back, the cause may be a degenerated disc. If sciatica is associated with pain over the sit bones(ischial tuberosites) in your butt, the cause is more likely to be pressure from sitting for long periods. Arthritis and bone spurs can also press on the nerve. Tumors are a rare cause of sciatica. Treatment depends on your specific cause. The physical therapists have given you good advice re seats and sitting position, as well as stretching. Big bellies put tremendous stress on the lower back, and even modest weight loss can be beneficial. Glucosamine has already been mentioned, but individual results are highly variable. If it works for you, it may take 3 months to see a response. Oral anti-inflamatories and ice can be helpful. Injections like Pierre had can be very beneficial in selected cases.

Most cases of sciatica are just a pain in the butt(or leg), and can be self-treated with the above measures. Some cases of sciatica can result in permanent nerve damage and loss of strength in the leg and/or foot. If you have consistent pain, loss of sensation or abnormal sensation down the back of your thigh or outside of your lower leg or top of your foot, see your doc. If you have loss of strength in those same areas, or trouble flexing your foot or toes upward, see your doc. Do not ignore, or self-treat, weakness in your leg or foot. Nerve damage can develop quickly and may take 18-24 months to heal. Left untreated, it may become permanent.

Jim Berry
RV-10
 
Pierre,

For ten years of my USAF career I flew various models of the F-4, all of which had the Martin-Baker ejection seat. The seat had a perfect record for saving pilot's lives, but it also had the bad habit of bending the lower spine in such a way that just sitting in the seat and pulling high "G's" was enough to cause disc damage. Every pilot I knew who bailed out of an F-4 suffered damage to his lower discs. I started walking five miles a day twenty years ago and have not had any issues with my back since. I'm almost 75 now and am down to three miles a day, but that is enough to prevent the back problems from returning.

Give it a try and see if it will help you. Good luck!

Jim
 
Pierre

Much younger, many fewer hours, but very similar as many others. No real pain when I was flying average 20 hour months. New job went instantly to 40-90/month and the lower back pain came on with a vengeance. Had the same Lumbar Epidural Steroid, helped a bit, now back to bigger Helo's and fewer hours, jury is out.
 
Mornin' all...pincushion here:mad:

After enduring a three-needle epidural and steroid injection, multiple bodily punctures yesterday, I wondered whether pilots have a greater number/ratio of men/women with sciatica than non-pilots.

I've endured 45 years and around 20,000 hours of flying, mostly ag and have been hammered by extremely rough air, every year...the worst hammering being in my RV's...because of their speed/low wing loading.

Does this beating have a long term effect on whether or not your chances of developing sciatic nerve/leg pain problems are greater than non-pilots, or could it be...in the words of Jimmy Buffett..."Yeah, it could be my fault"....for being 66:)

Thanks,

Hey Pierre

If you google my handle you might guess my day job. I believe the PT's have given good advice as has Jim especially regarding weight loss. Are you familiar with the results of your MRI? ESI's may be done therapeutically or diagnostically and may be done by different approaches. The transforaminal approach has been shown to be most effective for ESI's. I believe ESI's are best utilized as a part of a complete well organized rehab program which incorporates exercise, PT, attention to posture, and evaluation of surroundings such as do you have a firm mattress?

Pilots likely have a higher incidence of sciatica, especially helicopter pilots:

"Helicopter pilots with a vibration dose greater than 1,200 m2 h/s4 were 5.6 times more likely to have sciatica pain"

from here:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2200681/

You are likely correct regarding the low wing loading - wing loading is one aspect I enjoy in my current plane...

regards
 
Thanks

Steve, I have a tempur pedic mattress and simply love it...about ten years now and the best night's sleep a man can have....that and a contoured tempur pillow that supports your neck.

I also think that the lousy, welded up seat and ugly contours of my Air Tractor seat has a lot of blame here. There is an aftermarket tempur foam seat, marketed by the late Leland Snow's (Air Tractor founder), son-in-law that I'm going to look at, since I spend long days in that miserable webbing-covered contraption of a seat:) Both the seat and the backrest are concave from left to right:mad:

Best,
 
... I started walking five miles a day twenty years ago and have not had any issues with my back since. I'm almost 75 now and am down to three miles a day ...

Jim, my dad started walking a couple miles a day when he was your age ... and nobody's seen him since. :D
 
Pierre,

For ten years of my USAF career I flew various models of the F-4, all of which had the Martin-Baker ejection seat. The seat had a perfect record for saving pilot's lives, but it also had the bad habit of bending the lower spine in such a way that just sitting in the seat and pulling high "G's" was enough to cause disc damage. Every pilot I knew who bailed out of an F-4 suffered damage to his lower discs. I started walking five miles a day twenty years ago and have not had any issues with my back since. I'm almost 75 now and am down to three miles a day, but that is enough to prevent the back problems from returning.

Give it a try and see if it will help you. Good luck!

Jim

Not just the F-4 by any means, Jim! The BAE Hawk jet trainer is famous for its crappy ergonomics, with both neck and low back problems the norm for its pilots. My son is currently training on the T-38 at Sheppard, and he is now reporting that with a couple of longer cross-country flights he is starting to encounter low back problems as well; thought he might have dodged the bullet when he got sent south to train with USAF instead of on our Hawks, but apparently not:) I know that in the RCAF, most F-18 pilots' careers are limited by how long their backs hold out; pull that many g's for 7-8 years and discs go no matter how diligently you maintain core strength and stability, and no matter how well positioned and supported you are. And when support and position is less than optimal, as is often the case where seat design is dictated more by survivability in ejection than anything else, all bets are off. As for back problems following ejection, that's another matter altogether; massive compressive forces through the spine, usually resulting in either disc injury or very commonly compression fractures. No seat design can mitigate the pure brutal compressive force accompanying ejection, but it beats the heck out of the alternative!
 
Pierre,

My wife is getting Lumbar Epidural Steroid injections for lower back pain. It provides some relief but is not a cure so far. She will be going back for more consultation later this week. There's already been a MRI and a problem has been identified between #5 and #6 in her back, whatever they were called, I do not recall. The doctor making the diagnosis has not mentioned sciatica but the symptoms are the same. She has pins and needles down her left leg.

She is not a pilot. The problem may or may not be related to flying but more connected with personal bone structure and genetics. I have been flying since age 19 in the military and civil life and have never had lower back pain. (age 73 next month) But I have not flown anything sitting a web sling seat, either.
 
Wow.

Amazing amount of knowledge regarding this subject on here!

So, it seems that the consensus, in general, is that working pilots, whether military, airline or crop-dusters, are more prone to these sorts of maladies, no? Or anybody who sits for long periods..18 wheeler drivers, etc.

The remedies...take frequent walks, watch your weight, watch excessive G's, spend money on good, tempur foam type seats, exercise? Anything else?

Thanks to all,
 
Amazing amount of knowledge regarding this subject on here!

So, it seems that the consensus, in general, is that working pilots, whether military, airline or crop-dusters, are more prone to these sorts of maladies, no? Or anybody who sits for long periods..18 wheeler drivers, etc.

The remedies...take frequent walks, watch your weight, watch excessive G's, spend money on good, tempur foam type seats, exercise? Anything else?

Thanks to all,


That's pretty much it in a nutshell, Pierre. In the plane, it's all about proper position and support (which can be enhanced by simple solutions like AntiSplat Aero's inflatable lumbar support in addition to the high quality cushions already mentioned), and out of the plane it's all about core strength and stability, flexibility, regular cardio exercise and generally maintaining as high a degree of daily physical activity as you can.

Pat: Sounds like we should have a little "flying physios" side group here:)
 
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