For individuals with a history of lower back pain, a simple and accessible solution may be right at their feet—walking.
Researchers have discovered that following a structured walking program can significantly extend the time before back pain recurs. In fact, patients who adhered to a walking regimen were able to go nearly twice as long without experiencing a return of their backache compared to those who did not follow the program.
“A simple, low-cost, and accessible exercise strategy such as walking can prevent the recurrence of low back pain when coupled with education,” says lead study author Natasha Pocovi, PhD, a physiotherapist and researcher at Macquarie University in Sydney, Australia. The findings of this research were published in The Lancet.
Dr. Pocovi was particularly surprised at how the intervention impacted participants beyond just pain relief.
“We were surprised at just how much the intervention also could impact people’s lives aside from improving their low back pain,” she explains. “We had patients who reported improved sleep, mood, positive lifestyle changes, and improved management of other chronic health conditions.”
The Recurring Nature of Lower Back Pain
Lower back pain is the leading cause of disability worldwide, according to recent studies. More than 600 million people globally suffer from back pain, and this number is projected to rise to 843 million by 2050.
One of the biggest challenges with lower back pain is its tendency to return. Research indicates that 7 out of 10 individuals experience a recurrence of their back pain within a year after recovery. This highlights the urgent need for effective, long-term strategies to prevent back pain episodes rather than just treating them when they occur.
Challenges in Treating Lower Back Pain
Current physical therapy guidelines recommend a combination of exercise, manual therapy, and education as the most effective treatment approach. However, not everyone has access to professional treatment due to the high costs of physical therapy sessions, the need for professional supervision and limited accessibility to specialized healthcare services.
Given these challenges, a low-cost, independent, and effective method like walking could be a game-changer in managing back pain.
The Study: How Walking Helped Adults With Back Pain
To explore the impact of walking on back pain recurrence, researchers conducted a three-year clinical trial involving 701 adults who had recently recovered from an episode of back pain. Participants were divided into two groups.
The first was the Intervention Group, who followed a structured walking program and attended six physiotherapist-guided education sessions. And the second was the Control Group, who did not receive any specific treatment or instruction.
At the start of the study, both groups reported walking for about 70 minutes per week on average. However, the intervention group was encouraged to increase their walking time gradually, with a goal of walking five times per week for at least 30 minutes per session by six months.
Education: Key to Confidence and Prevention
The education sessions provided to the intervention group aimed to:
- Enhance participants’ understanding of pain
- Reduce the fear associated with movement and exercise
- Build confidence in managing pain independently
- Teach strategies to prevent back pain recurrence
- Offer self-management techniques for minor back pain episodes
Participants were monitored for one to three years to track the recurrence of back pain and measure overall health improvements.
Results: Walking Significantly Reduces Pain Recurrence
The study revealed impressive results for those who followed the walking program:
- The intervention group remained pain-free for an average of 208 days, compared to 112 days for the control group.
- Participants in the walking group reduced their risk of experiencing a debilitating recurrence of back pain by 28%.
- They were 43% less likely to require medical care for their back pain compared to those who did not participate in the walking program.
“Particularly in more sedentary individuals, a dedicated walking program may help address deconditioning that can occur with movement avoidance and buffer against future pain episodes,” says Beth Darnall, PhD, professor of anesthesiology, perioperative, and pain medicine at the Stanford Pain Management Center in Redwood City, California.
The study also highlighted other benefits of walking, which included an improved quality of life, less reliance on healthcare services, and reduced missed workdays due to pain.
Why Walking Helps Alleviate Back Pain
Experts believe that walking helps with back pain in several key ways, such as strengthening and engaging muscles. Moreover, walking engages multiple muscle groups. These include the core muscles, which provide spinal support, the lower back muscles, which improve posture and stability, and the leg muscles, which reduce strain on the lower back.
According to John Alm, DO, chair of the Department of Physical Medicine and Rehabilitation at West Virginia University Health System, walking also stretches fascia (connective tissue) and soft tissue structures around the spine, helping to alleviate stiffness.
Another thing that walking does is help in releasing natural pain-relief hormones. Walking triggers the release of serotonin, a neurotransmitter that improves mood and reduces stress, as well as endorphins, the hormones that act as natural painkillers.
“Exercise can help reduce stress by releasing [the feel-good hormones] serotonin and endorphins to mitigate how we experience pain,” explains Dr. Alm.
A third thing walking aids with is in enhancing blood circulation. Walking increases blood flow, which delivers nutrients and oxygen to muscles, ligaments, and tendons, promoting healing and reducing inflammation.
Limitations of the Study
Although the findings were promising, the researchers acknowledged some limitations, including:
- 81% of participants were women between the ages of 43 and 66, meaning the results may not be fully generalizable to men or younger individuals.
- The study did not account for whether participants in the walking group also engaged in other beneficial activities such as stretching, core strengthening, or yoga, which are also known to help with back pain.
“What this study does not account for is whether the walking group engaged in other activities such as flexibility programs or core strengthening, activities that are also known to be helpful in strengthening the back and reducing low back pain,” notes James Gladstone, MD, chief of the Division of Sports Medicine for the Mount Sinai Health System in New York City.
The Importance of Prevention Over Treatment
Historically, most back pain treatments have focused on managing pain episodes rather than preventing them. However, Dr. Pocovi and her research team believe this study may help shift the focus toward prevention.
Walking: A Free and Accessible Solution
Dr. Alm recommends that individuals with back pain incorporate walking into their daily routine.
“The best part of walking is that it is free, easy to do, very accessible, and can be adapted to almost all levels of physical ability,” he emphasizes.
Unlike expensive treatments or medications, walking requires no special equipment, can be done anywhere, and is suitable for all fitness levels.
Final Thoughts: Can Walking Prevent Your Next Back Pain Episode?
For millions of people worldwide who struggle with recurring back pain, this study offers hope. By committing to a regular walking routine, individuals can not only prolong their pain-free periods but also improve their overall well-being.
While further research is needed to explore its effectiveness across different demographics, one thing is clear—walking is a simple yet powerful tool in the fight against lower back pain.
If you’re looking for a low-cost, easy, and effective way to manage and prevent back pain, start walking today!