Walking Consistently May Help Reduce Back Pain

Walking Consistently May Help Reduce Back Pain

People had less frequent episodes of low back pain when they walked regularly, according to a new study.

The research, published on June 19 in The Lancet, highlights the importance of walking as a simple health intervention, especially given the toll low back pain takes on patients and the healthcare system at large, experts said.

Data from 2020 suggests about 619 million people experience low back pain, and researchers estimate that number will increase to 843 million by 2050.

Typically, when it comes to addressing low back pain, “the adage of ‘prevention is better than cure’ [is] left to the wayside,” said Natasha Pocovi, PhD, first author of the study and researcher in the Department of Health Sciences at Macquarie University in Australia.

However, “if we can target the prevention of back pain, that’s going to help the healthcare system immensely,” Pocovi told Health.

The study’s results are also promising because, unlike many forms of activity, walking is a safe and accessible exercise for most people, added Paul Cooke, MD, assistant attending physiatrist at the Hospital for Special Surgery in New York.

“Almost all people can benefit from daily walks in some capacity,” Cooke told Health.

Here’s what experts had to say about the study, why walking may prevent back pain, and what to consider before adding more steps into your daily routine.

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To investigate the relationship between walking and back pain, Pocovi and her team followed 701 adults who had recently experienced an episode of low back pain. The study participants were, on average, 54 years old, and 81% of them were women.

In the study, an “episode” of low back pain was defined as lasting at least 24 hours and hitting at least a two on a zero-to-10 numerical pain scale. These episodes were also “not attributed to a specific diagnosis” and were significant enough to at least partially limit a person’s day-to-day activities.

The participants were split into an intervention group and a control group; those in the intervention group received six guided education sessions with a physiotherapist and a walking plan. These walking programs were individualized, but the participants in the intervention group were encouraged to work up to a regimen of five 30-minute walks each week over the course of six months.

The study began in September 2019 and ended in June 2022, and Pocovi’s team followed the two groups for one to three years. The participants wore accelerometers for seven days, three months after starting the study—this allowed researchers to track their step counts and number of brisk-walking steps.

After analyzing the data, the study authors found that participants in the control group were more likely to have a recurrence of back pain before those who walked regularly. On average, people in the control group suffered another episode of low back pain after 112 days, while the walking group saw an average of 208 days before a recurrence.

“We always had a hunch that the walking was going to work, but we were surprised to see that such a simple intervention was as effective as it was,” Pocovi said. “It really emphasizes [the benefits] of keeping people active.”

Though the results are intriguing, there are a few limitations.

For one, the participants did not wear accelerometers for the entire study, so it’s difficult to say whether the noted benefits of walking plateaued at a certain pace. Plus, the large majority of the participants in the study were women. Low back pain is more common in women, but it’s not clear if the findings of this study are universally applicable.

As for why walking might be able to prevent low back pain, experts agreed the two are closely connected.

“Regular walking helps strengthen leg and core muscles, enhance aerobic capacity, control body weight, and reduce stress and tension,” Cooke explained. “These can all contribute to improving back pain.”

And walking doesn’t just help with low back pain—in general, “movement eases pain because it can decrease stiffness and fatigue that occurs when being sedentary,” Elizabeth Yu, MD, an orthopedic surgeon at The Ohio State University Wexner Medical Center, told Health.

Beyond pain relief, a regular exercise or walking routine can also “help increase strength, mobility, mood, and energy,” Yu said.

For those looking to give walking for low back pain a try, they should be able to do so safely. However, people with certain health conditions may want to speak with a provider before significantly altering the number of steps they take each day.

“Before starting, people with a history of heart, lung, or circulation problems, or those who have been recently hospitalized, should check with their doctor,” Cooke said. “Patients who are receiving physical therapy for an injury or condition can discuss with their therapist about potentially incorporating regular walking into their home exercise program.”

Also, for those struggling with low back pain, remember that “the exercise does not need to be strenuous, particularly when one is in pain,” Yu added.

If you haven’t been active in a while, it’s a good idea to build up to a brisk walk. A sample walking plan from the National Heart, Lung, and Blood Institute recommends people start off walking 10 minutes daily four times a week and slowly increase their walking time, pace, and frequency. By the end of two months, a person should aim to walk briskly for 35 minutes five times a week.

Also, before starting a new walking regimen, everyone should consider certain safety precautions, Cooke said. These include:

  • Making sure you have properly supportive footwear
  • Either walking with a partner or making sure a friend or family member knows when they can expect you to return from your walk
  • Eating a snack and drinking water before starting out to stay hydrated and energized
  • Being mindful of the weather so that you don’t spend excessive amounts of time in dangerous temperatures
  • Staying aware of your surroundings while on a walk

It’s normal to experience some soreness as you start a new exercise routine. But anything other than mild discomfort should prompt you to pause and speak with a physician.

“It is important to consult with a medical professional if one has had a major episode of pain,” Yu said.

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