Astronauts Williams and Wilmore Face Potential Long-Term Back Pain After Space Mission
NASA astronauts Sunita Williams and Barry Wilmore may experience persistent and severe back discomfort following their recent nine-month mission in space.
Prevalence of Back Pain Among Astronauts
Research indicates that approximately one-third of astronauts who spend extended periods in space develop chronic back problems due to spinal changes in a zero-gravity environment.
Almost all astronauts experience acute pain, including NASA’s Frank Rubio, who spent a record 371 days on the International Space Station (ISS). Rubio reported a recovery period of two to three months to regain normalcy after returning to Earth.
Spinal Impact of Zero Gravity
Medical experts explain that the absence of gravity on the ISS reduces spinal compression, leading to spinal straightening and elongation. Upon return to Earth, the spine gradually returns to its usual configuration but in a weakened state.
This weakening also affects back and core muscles, which are crucial for spinal support and protection.
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Recovery Timeline for Williams and Wilmore
Williams, 59, and Wilmore, 62, concluded their 286-day space journey on Tuesday. Doctors caution that their recovery to full health may be lengthy.
Dr. Ehsan Jazini, a spine surgeon at VSI, stated to DailyMail.com that based on their mission duration, it could take at least three to six months for them to feel completely normal and potentially longer for their spines to fully recover to their pre-flight condition.
NASA astronaut Frank Rubio, who spent 371 days on the ISS before returning in September 2023, experienced significant back pain following his extended mission.
Past astronaut experiences suggest recovery could take up to 1.5 times the mission length, indicating Williams and Wilmore might require over a year to fully recuperate.
Dr. Jazini outlined their rehabilitation program, which is expected to include gradual core and spinal stabilization exercises, stretching, mobility work, and a slow return to high-impact activities, alongside monitoring for herniation or persistent pain indicators.
“NASA’s medical teams are well-prepared for this, but considering the length of their mission, a prolonged recovery period is anticipated,” Dr. Jazini noted.
“As I advise my patients, rehabilitation requires considerable patience and consistency.”
Factors Influencing Pain Severity
Experts indicate that the intensity and duration of back pain for Williams and Wilmore will depend on their bone health. However, many astronauts have described lower back pain as severe and characterized by spasms.
Dr. Deena Adimoolam, a specialist in bone disease and endocrinology at Summit Health, explained that “In space, the spinal column expands due to the lack of gravity.”
“Upon astronauts’ return to Earth, spinal compression occurs due to gravity, potentially leading to back pain,” she added.
Simultaneously, the low gravity on the ISS contributes to bone density loss and muscle weakening, further affecting the back and spine.
Sunita Williams and Barry Wilmore returned to Earth off the coast of Tallahassee, Florida on Tuesday, concluding their 286-day space mission. Williams is pictured giving a thumbs-up after exiting the Dragon capsule.
Williams and Wilmore were assisted onto stretchers by NASA medical personnel, a standard procedure for astronauts experiencing muscle weakness after time in microgravity.
Muscle Atrophy and Spinal Instability
These combined effects diminish spinal strength and stability, potentially causing both acute and chronic pain.
Dr. Michael Eng, an orthopedic surgeon at Hoag Orthopedic Institute, mentioned that Williams and Wilmore “can expect some level of muscle atrophy, even if minor.”
“Core muscle atrophy can impact posture and, depending on its severity, elevate the risk of disc herniation,” Dr. Eng elaborated.
“The weakened core includes paraspinal muscles, which are vital for safe spinal function.”
Mission Duration and Exercise Regimen
Williams and Wilmore spent 286 days in space before landing off the Florida coast on Tuesday evening.
Like all astronauts, they adhered to a daily exercise routine of at least two hours to mitigate bone and muscle loss. However, prolonged space exposure can complicate recovery upon return to Earth.
“Even with pre-landing conditioning, the shift back to Earth’s gravity is a significant adjustment for the spine, as nothing fully replicates this sudden transition,” Dr. Jazini explained.
Rubio, after over a year in orbit, reported that regaining his pre-flight physical condition took months.
In a January 2024 Time Magazine interview, Rubio described his rehabilitation as involving “lots of exercise, lots of testing, and science.”
Research on Astronaut Back Pain
A recent study revealed that 77 percent of astronauts experience back pain during spaceflight, 47 percent report acute pain post-return, and 33 percent suffer chronic pain long after missions.
Similar to Williams and Wilmore, Rubio’s extended stay in space was unexpected.
Initially launched on the Soyuz MS-22 spacecraft on September 21, 2022, his mission was intended to be a typical six-month ISS stay.
However, his mission was prolonged due to space debris impact on Soyuz, causing a coolant leak.
Reduced gravity lessens spinal compression, leading to spinal straightening and lengthening. Astronauts may grow up to three inches taller in space.
NASA astronaut Raja Chari performs strengthening exercises following a 177-day ISS mission. Astronauts typically undergo a 45-day rehabilitation program after long space missions to reverse the impacts of low gravity on muscles and bones.
A replacement Soyuz spacecraft was dispatched to retrieve Rubio and his Russian crewmates, who returned on September 27, 2023.
Like Rubio, Williams and Wilmore will undergo a comprehensive rehabilitation program to counter the effects of their nine-month mission.
This program is expected to last approximately 45 days, requiring two hours of daily exercise, seven days a week.
Phases of Astronaut Rehabilitation
While customized, the rehabilitation generally includes three phases:
Phase One: Regaining Basic Mobility
Phase one emphasizes restoring strength, flexibility, and walking ability. This includes gait training, range of motion exercises, and obstacle course work.
- Gait training exercises: Enhance strength, balance, and coordination for walking, including squats, leg raises, single-leg stands, and marching.
- Range of motion exercises: Improve flexibility with ankle pumps and stretches for calves, quadriceps, and hamstrings.
- Obstacle training: Improves coordination by navigating obstacle courses or stepping over objects.
Phase Two: Proprioceptive and Cardiovascular Reconditioning
Phase two incorporates proprioceptive exercises and cardiovascular training.
- Proprioceptive exercises: Strengthen body awareness of movement and position, including reverse lunges, banded toe taps, and sumo squats with leg raises. More complex exercises may involve single-leg object pickups, requiring balance and waist hinging.
- Cardio training: Utilizes treadmills, ellipticals, or stationary bikes to restore pre-flight endurance.
Phase Three: Functional Development Training
Phase three, the longest, focuses on achieving optimal physical performance through functional training.
This stage aims to restore skills for daily life and job functions, including high-intensity exercises like jump squats, jump lunges, mountain climbers, planks, and deadlifts.
NASA reports that most astronauts regain pre-mission fitness within 45 days.
However, full recovery can take months or years for some, and research indicates that some astronauts never fully recover bone density.
Dr. John Jaquish, a biomedical engineer, previously told DailyMail.com that osteogenic loading exercises could potentially restore pre-flight bone density but require significant effort.
These exercises, such as squats, lunges, or jumping, strengthen bones by applying stress.
Dr. Jaquish stated that to stimulate bone growth, astronauts’ bones need to bear loads 4.2 times their body weight.
“For context, the world record squat is only four times body weight, so the minimum [weight] needed exceeds world record levels,” he mentioned.
Medical professionals suggest Williams and Wilmore face a risk of chronic back pain or may need months of physical therapy to address acute back pain resulting from their extended space mission.