Lower Back Ache From Commuting in Bangkok

Lower-back ache gets much less attention than neck and shoulder tension, which is odd, because for anyone who commutes in this city it is at least as common. It also has a clearer cause and a more reliable response to treatment.

Sitting still is the problem, not sitting

A car or taxi seat in Bangkok traffic is a peculiar load. You are seated, which flattens the natural curve of your lower back and shifts load onto the discs and the muscle either side of the spine. You are also braced slightly, because stop-start traffic means constant small corrections. And you hold it for forty minutes, twice a day, without the postural variation that even a bad office chair allows.

Standing on the BTS is different but not better. You are stable, upright and largely motionless, usually with a bag on one side, which loads one side of the lower back more than the other. That asymmetry is why so many people describe the ache as worse on one side.

How to tell it is postural

Three signs that point to a muscular, load-related problem rather than something structural:

• It is worse after sitting and eases within a minute or two of walking.
• It is a dull, diffuse ache across the low back rather than a sharp point.
• It does not travel down a leg, and there is no numbness, tingling or weakness anywhere.

If any of that last point is untrue — pain into the buttock or leg, numbness, weakness, or pain that wakes you at night — that is a doctor or a physiotherapist first. It is not a reason to avoid massage forever, but it is a reason to find out what you are dealing with before somebody works on it.

What helps on the commute itself

Move the bag. Across your body or on both shoulders. One-sided loading is the easiest of these to fix and the one people ignore longest — there is more on it in what commuting without a car does to your shoulders.

Sit back in the seat. In a taxi, all the way back rather than perched forward. A rolled jacket or a small cushion behind your lower back restores some of the curve that sitting removes, and it makes a noticeable difference over forty minutes.

Stand up at the other end. The transition matters. Two minutes of walking before you sit down again at a desk breaks the chain of one seated position straight into another.

Which treatment

For a lower back that has been loaded for months, firm and specific work is what helps. Deep tissue massage is focused work on particular areas of tension — persistent knots, or one area that will not release — from ฿1,400 for sixty minutes. Be ready to say clearly what hurts and how firm you want the pressure; some soreness the following day is normal.

If the whole back and hips feel stiff rather than one spot being sore, traditional Thai massage is the better choice. It is dry pressure with assisted stretching, on a mat, no oil, from ฿900 — and the stretching is the part that helps a hip and lower back that have not moved through their full range in a while.

For a lower back specifically, ninety minutes is usually better value than sixty: ฿1,100 for Thai, ฿1,600 for deep tissue. An hour tends to get spent on the upper back before it reaches the part you booked for.

Do not massage an acute injury

Deep tissue work is not appropriate over an acute injury, an inflamed joint, or where you take blood-thinning medication without advice first. Tell us before booking if any of that applies, or if you are pregnant, have osteoporosis, a slipped disc or have had recent surgery — the treatment pages list what to mention and we would rather know beforehand.

You can book a session at your address, compare treatments on the services page, or start from the home page.