How can I fly for 13 hours with a back pain? On economy

I have arthritis pretty much throughout my spine and just had pain block injections last week, so sitting in economy while flying to SE Asia to visit my wife’s family can be excruciating. I usually don’t recline my seat either, as that seems to make it worse, but sometimes you have little choice if the people in front and back of you are inclined. What I’ve learned to do is to keep a supply of Panadeine only for flying. Panadeine isn’t available in the US where I live so I have to bring it back from our trips, or if Canada’s open it’s available there. There’s just enough codeine in it to keep the pain knocked back, but not so much that I get nauseous from taking it (like I would with prescription Tylenol III or similar). You need to stay on top of your pain, I know that I need to take one 500mg Panadeine every 4 hours or so to remain pain free enough to be somewhat comfortable, maybe even sleep (rare).

Edit: we almost always upgrade to economy+ for the extra legroom. My wife doesn’t need it, but at 6′-2" it makes a difference for me even if it costs us an extra $600 or so for our two seats to be upgraded.

Obviously taking a narcotic is less than desirable, but it’s what I’ve learned to do. I also bring Voltaren or a generic for diclofenac gel (if you’re in the US, both Walmart & Costco sell a generic now that’s quite reasonable). Yes, it’s a bit smelly, but it’s not an unpleasant smell, and it doesn’t last long as its absorbed into your skin. It also wasn’t available in the US until very recently, so I’d have to bring it back from trips like the Panadeine.

Also, Panadeine’s not exactly legal to have in the US, although I’ve never had a customs agent confiscate it on either end of the trip. I also never fly into Singapore or Malaysia with prescription narcotics of any kind except Tramadol (which is not on either of their illegal drugs schedules, something you do NOT want to mess with over there). Do your own research and don’t trust mine, I haven’t flown to SE Asia (or anywhere else) for several years so things might have changed.

We also spend time on checking out our plane’s seating arrangement to locate the best seats where there’s some extra room for a bit of stretching and the fewest people around us, usually toward the tail of the plane. My wife is small, so she can curl up in a seat, but I’m football player sized, so I’m generally bigger than the seats can comfortably accommodate. As long as we’re seated together, this isn’t a big deal because I can just use some of her unused space so my shoulders aren’t out in the aisle (another reason to check the seating arrangements to maximize the aisle width so you’re not getting bumped by the cart every time they go by). Some flights are really good about not hitting you or at least letting you know they’re coming (China Air, Delta), others seems to do it deliberately to punish you for being in the way (United).

Are you able to take the same trip by train?

There’s a lot more ability to move up and down the aisle, and there may exist sleeper facilities on the route.

Even if only part of the trip can be via train, a connecting flight will then be shorter and perhaps more tolerable, or can be replaced by a rental car where you’re moving about in the seat a bit more.

Depending on what you’re willing to spend (how important the trip is and how frequently you go on these kind of trips), you could consider upgrading to first class. Not all, but quite a handful of airlines provide you an actual bed, sometimes within your own room on the airplane.

One more point: research the plane and the seat carefully before you book. A site like www.seatguru.com is good for this. You can check layout, pitch, width and read reviews from other passengers.

The difference can be profound. For example United flies multiple versions of the Boeing 777. The older ones have 3-3-3 seating while the new "high density" ones have 3-4-3 seating in economy. It’s the difference between a tolerable experience (even for 16 glorious hours from EWR to HKG) to absolute misery. Consider paying extra or routing differently to avoid a "bad" plane (if possible).

There is small chance that you plane will be swapped out or that seatguru gets it wrong, but this is quite rare.

Right now airlines are packing flights as full as possible in an effort to recoup losses from the past 18 months. If you’re looking for extra room in economy or free upgrades you better have status(which from your asking means you most likely don’t). To be completely honest, if you need to lay down for a long flight then you should pony up for the First/Business Class or Premium Economy upgrade. If you can’t do that then I’d highly advise postponing your trip.

If the trip is for business then assuming you have seen a doctor regarding your back issues tell your manager that you have medical issues and that you will be upgrading your seat to first class in order to alleviate them.

If none of the above are possible, make an appointment to go see your doctor and ask them how you can alleviate the back pain. Physical therapy and chiropractic appointments did wonders for my sciatica to the point to where it took 2 weeks for most issues to subside and 8 weeks for all symptoms to go away.

Edited: Changed the business use case to specify managerial approval.

There is nothing you can do but move around during the flight as much as the crew let’s you. I have had severe back issues in different parts of my life. I was on an overseas flight where I threw up because it got so bad.

You can buy better seats or buy 2 or three seats next to you. This may make it less painful but its not going to save you.

You for sure cannot count on the airline to help you. You don’t get free upgrades because of a bad back. Also the gate/ticket counters will always say "if there are open seats next to you we will see what we can do".

No – in 90%+ of the flights I have taken the gate crew makes no attempt to ever talk to the attendants about anything like this.

And to make matters worse empty areas of the airplane are basically treated like a Thunderdome Arena with very little rules.

• If there are open seats some attendants will let you move right after boarding.
• If there are open seats some attendants make passengers wait until after the seatbelt sign has been turned off during take-off.
• I have been on many a flight where one attendant makes up one rule (please sir take your seat) and bam 5 people move right behind you under the orchestration of another attendant.

You can schmooze attendants or try to play the pity case but your results will be somewhat random. If you are slow because your back hurts, that does not make anything better. I have always been aggressive claiming space and just assume that once everyone is on the plane I move where I want (doesn’t always work). If it doesn’t work you go back and try again later.

I was on a flight where I had staked out an open row. Teenage girl saw this (and she had an open seat next to her). Well I got sent back to my seat. We are climbing in the air and bam… before that seatbelt sign goes off she takes the row – 5 seats… Ok so it’s on. She made a strategic mistakes, she started lounging in the second seat. I took the middle. She says – I was about to lay down here. I say – me too. Thunderdome!

The pitfalls of staking out an open claim like this though is like others have said not all middle rows let all the arm rests up – ways around this though. And also if you do get a row like this you cannot really just walk around the plane stretching and stuff or someone is going to claim your ground. Basically you got to leave a bunch of your crap there (shoes and socks are key) and you need to stay a substantial amount of time before leaving for more than a quick bathroom break.

Paying a little more option: I hate to give an option that costs more because people saying upgrade to business or first class… well I go over to London often. Around ~1100. Business is ~4500-6000 and first class ~8000-12000. But the economy plus are an extra 100-150 each flight. So might make the trip ~1400. Anyways if you can get in the first row of a section of economy plus that is the best you can do for your back.

Break the flight into two 7 hours segments. Sleep/Lie down in between the segments at the airport. One advantage of this is that the flight is most likely cheaper then a non-stop one. Disadvantage is the trip will take forwever.

There aren’t many answers for this. I too have lower back pain and sciatica. It sucks.

1. If you get a seat next to you, or ideally 4, you could stretch out. This is not usually common, although rumour has it planes on average are less full at present, depending on the route.
2. Stretches. Depending on your back injury, speak with a physio beforehand about exercises you could do in the aisle or even in your seat every 30 min or so.
3. Painkillers and Voltaren/deep heat. Deep heat saves me, seriously. Downside is it has quite the aroma.
4. Upgrade. Pay for premium or business if available. The pain to your wallet may be worth it to your back, and might be cheaper than physiotherapy bills.
5. Grin and bear it. Sometimes suffering is the last and only option. It’s only 13 hours. It will end. Try and sleep as best as you can.

Unfortunately, lying in the aisle is not an option and is usually banned by most airlines for safety reasons.