If you've ever watched the TV sitcom "Seinfeld" you might remember the episode where one of the show's characters "George" shows his friend Jerry his gargantuan-sized wallet.  The wallet was so crammed full of stuff it was more like a filing cabinet than something that you should put in a back pocket!  Needless to say, George was having a fair amount of back pain and eventually had to stuff his other back pocket with knapkins to even things out.

I notice something similar in my office from time-to-time.  It usually presents the same way each time.  I'll get a new male patient with acute low-back pain.  In the course of a normal work-up, I'll notice that the man has an enormously thick wallet!  Often I will measure it just to see just how thick it actually is.  The largest I have come across was 2 inches thick!  Needless to say, the gentleman it belonged to was experiencing quite a bit of low back pain!

Large wallets function as something called an "Ischial Lift."  That means when you sit on it, it causes one side of your pelvis to sit higher than another.  This can cause a stiff back, a spinal misalignment called a "subluxation", potential injury to nerves, ligaments, muscles, and tendons, and generally make it easier for you to injure your back.

So what to do?  Put that big, old, fat wallet on a diet.  Discard anything that you haven't used in a month or two.  If you find your wallet is still too thick to sit on, consider putting it in the front pocket.  If that doesn't work for you, try alternating back pockets every week or so.  This will hopefully help even out the postural stress that is created with a "George Castanza-sized Wallet."  Making these changes will make it easier for you to avoid a preventable cause of Acute Low-back Pain.