Paris said truck drivers also face logistical challenges. They spend most of their time on the road, often making it difficult for them to find time to see a specialist concerning their pain. Paris said without the ability to manage Strating's pain through medication, there are not many choices for truck drivers like Strating. Aside from the over-the-counter aspirin Strating occasionally takes, he said he cannot do much to manage his pain.
"I can't operate a truck and be on medication," Strating said. "I've just gotten used to [the pain]."
Paris added, "Anyone left with chronic pain and limited options feels like on some level they 'live with it' -- and in fact they do."
Strating said he has gotten used to painful days and does not think about leaving his job to relieve his back pain.
"I've done this for so long now," Strating said. "I know the routine and it makes a living for me."
Todd DeClairmont felt the familiar speed of his fighter jet as inertia locked him into his seat during flight. DeClairmont said he suffered severe spine compression and neck pain from the force and speed of the plane -- but refused to see a chiropractor at the time.
"I didn't want to take time away from flying," DeClairmont said.
Gary Kearney, senior medical examiner for the Federal Aviation Administration, said it is common for fighter pilots not to report pain they feel while flying.
"Fighter pilots are concerned about reporting even minor complaints because it could jeopardize their time in the air by being grounded by their flight surgeon," Kearney said. "They always want to feel on top of their game."
DeClairmont said he eventually gave in to the pain and saw a chiropractor. That was nine years ago, when DeClairmont served as a fighter pilot with the U.S. Air Force. DeClairmont now flies commercial airplanes and said the greatest strain on his back is carrying his navigation bag -- a carrier that contains chart cases and flight manuals pilots need to map their route.
"I only carry the bare minimum in my bag, and it's 37 pounds," DeClairmont said.
Like many commercial pilots, DeClairmont sometimes switches airplanes multiple times a day, which has him rushing through different terminals, navigation bag in tow.
"I can feel myself leaning sideways when I'm walking with my bag," DeClairmont said.
The FAA has approved the use of Electronic Flight Bags -- a device that stores a pilot's information electronically. However, many airline companies have not implemented its use among their pilots.
Kearney said that concern over being grounded can keep commercial pilots from telling their medical examiner about secondary pain.
"If older pilots only have a few more years left before they're grounded, they generally will not hasten that time by reporting anything minor," Kearney said.
Vahe Talatian, a licensed airline transport pilot, began flying 24 years ago. For the last three years, Talatian has been flying corporate jets. Unlike working for a large commercial airline where a pilot may change planes for a different flight path, Talatian flies the same airplane to every destination.
"I'm sitting in close quarters on one airplane the whole time," Talatian said. "After three or four hours, you feel fatigue from sitting and that need to walk around."
Kearney said pain management techniques specific for a pilot is unusual.