Back, Neck and Circulation: Surviving Sitting All Day in the Truck

Your body wasn't designed to sit for 11 hours, then climb down and crank a landing gear handle. Back, neck and leg problems are some of the most common complaints drivers have, and a few are dangerous if you ignore them. NIOSH lists little physical activity and long hours among the main health challenges of long-haul driving (NIOSH). The good news: small changes in how you sit and move make a real difference.

Set up your seat right

Do this every time you get in a different truck, and recheck it on long days. Make adjustments only when parked.

1. Hips all the way back in the seat so your low back touches the backrest.
2. Seat height: knees about level with or a little lower than your hips, with your feet reaching the pedals fully without stretching.
3. Seat distance: you can push the clutch or brake all the way down with your knee still slightly bent.
4. Backrest: slightly reclined, not straight up and not laid back. You should be able to see over the wheel without your chin poking forward.
5. Lumbar support: adjust it to fill the curve of your low back at about belt level. No built-in lumbar? A firm cushion or rolled towel works.
6. Air ride and suspension: set it per the seat's instructions for your weight so it absorbs bumps without bottoming out. If the seat is worn out, report it — a broken seat beats up your spine every mile.
7. Steering wheel: tilt and telescope so your arms are relaxed with elbows slightly bent and shoulders against the seat.
8. Mirrors: set them so you can see with only your eyes and a small head turn while sitting tall. If you have to slouch to see your mirrors, your mirrors set your posture.
9. Wallet out of your back pocket. Sitting on it for hours tilts your pelvis and can press on the sciatic nerve area.

Break up the sitting

• Use every stop. At fuel, at the shipper, during your 30-minute break: get out, walk for 2–5 minutes, do some calf raises.
• Move in the seat (while parked or stopped in traffic, never in a way that distracts you): shift position, squeeze your glutes, roll your shoulders.
• Stretch before work. Before you crank, slide tandems, tarp or unload, walk and stretch for a minute so you aren't lifting with cold muscles.
• Try the 10-minute workout most days. Hip flexor and hamstring stretches help the low back; chin tucks and chest stretches help your neck.

Protect your back on the job

• Three points of contact in and out of the cab and trailer. Don't jump down — the landing jars your spine and knees, and NIOSH lists slips, trips and falls as a cause of driver injuries.
• Lift with your legs, keep loads close to your body, and don't twist while holding weight. Turn with your feet.
• Landing gear: use low gear when you can, keep your back straight, and use your body weight instead of jerking the handle.
• Fifth wheel and tandem pins: if they're stuck, don't fight them with your back. Rock the truck, use the right tool, or get help.
• Ask for help with heavy freight. Lumpers and a hand truck cost less than a back injury.

Neck and shoulders

Hours with your head forward and shoulders rounded load the neck. Every hour or so when you stop: 10 chin tucks (pull your chin straight back, hold 3 seconds), 10 shoulder rolls backward, and a chest stretch in the door frame. Sleep matters too — a pillow that keeps your neck straight in the bunk helps.

Blood clots (DVT): the one you can't ignore

When you sit still for long periods, blood can pool in your legs and form a clot in a deep vein — deep vein thrombosis (DVT). If part of the clot breaks off and travels to the lungs, it's a pulmonary embolism (PE), which can be fatal. CDC says anyone traveling more than 4 hours by air, car or bus can be at risk, and that risk generally goes up the longer you're immobile (CDC: Blood Clots and Travel).

Your risk is higher if you are older (risk goes up after 40), overweight, had a recent surgery or injury, had a clot before, have a family history of clots, have cancer, or have certain heart, lung or diabetes conditions, according to CDC.

Lower your risk:

• Move your legs often and work your calves: walk at stops, do calf raises, and while parked straighten your legs and pull your toes toward you.
• Drink enough water.
• If you've had a clot or have other risk factors, ask your doctor whether graduated compression stockings or other steps make sense for you. If you take blood thinners, follow your doctor's instructions.

Warning signs

CDC notes that about half of people with DVT have no symptoms, and you can have a PE without warning signs in the leg.

About your medical card: FMCSA's advisory criteria say anticoagulation therapy for DVT or PE is not disqualifying once the optimum dose is achieved, provided leg vein exams remain normal and your treating physician gives a favorable recommendation (FMCSA). Bring your doctor's letter to your DOT physical.

Sciatica basics

Sciatica is pain, weakness, numbness or tingling in the leg from pressure on or injury to the sciatic nerve — often from a herniated disc or narrowing in the spine. It usually affects one side and can get worse after sitting, or when you cough or sneeze (MedlinePlus: Sciatica). Many cases improve with time, activity and the right treatment, but get it checked if it isn't getting better.

Contact a doctor right away if you have back pain with: loss of control of urine or stool, weakness or numbness in your buttocks, thigh, leg or pelvis, pain after a hard fall or blow, fever, or pain that is severe and won't let you get comfortable (MedlinePlus). Also get checked if an episode of back pain lasts more than 4 weeks.

Hemorrhoids

Hemorrhoids are swollen veins around the anus or lower rectum. NIDDK lists causes including straining during bowel movements, sitting on the toilet for long periods, constipation and a low-fiber diet (NIDDK). On the road, the usual culprits are not enough fiber or water and putting off bathroom stops.

• Eat more fiber: fruit, vegetables, beans, oats, whole grains. See our healthy eating guide.
• Drink water through the day.
• Don't strain or sit on the toilet scrolling your phone.
• Get up and move during long days.

See a doctor for any rectal bleeding. It's often hemorrhoids, but NIDDK notes bleeding can also be a sign of other bowel diseases, including colon or rectal cancer.

When to see a doctor

• Back or neck pain that lasts more than a few weeks, keeps coming back, or wakes you at night
• Numbness, tingling or weakness in arms or legs
• Leg swelling, pain or redness (possible clot)
• Rectal bleeding

Urgent care clinics take walk-ins in most towns, and telehealth can help you get started on the road. Tell the doctor you drive for a living — some medications cause drowsiness and can affect your ability to drive safely and your medical certification.