In my Insight, I changed the seats out. For whatever reason I could not make the stock seats comfortable for me. I tried pillows, lower lumbar support, sitting a dozen different ways, and while some provided minor improvement in lower back pain, all still hurt on drives longer than maybe 45 minutes (and when I got the car I was in my early 20's).
The new seats add around 40lbs to the car but they don't hurt me. What's surprising to me is that I can't really identify why the new ones don't hurt. They're no softer or firmer, and they're shaped fairly similarly. They're even from another Honda and probably have similar design origins.
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