Walking can prevent lower back pain, new study shows (2024)

Do you suffer from low back pain that recurs regularly? If you do, you’re not alone. Roughly70% of peoplewho recover from an episode of low back pain will experience a new episode in the following year.

The recurrent nature of low back pain is a major contributor to theenormous burdenlow back pain places on individuals and the health-care system.

In our new study, published inThe Lancet, we found that a program combining walking and education can effectively reduce the recurrence of low back pain.

The WalkBack trial

We randomly assigned 701 adults who had recently recovered from an episode of low back pain to receive an individualised walking program and education (intervention), or to a no treatment group (control).

Participants in the intervention group were guided by physiotherapists across six sessions, over a six-month period. In the first, third and fifth sessions, the physiotherapist helped each participant to develop a personalised and progressive walking program that was realistic and tailored to their specific needs and preferences.

The remaining sessions were short check-ins (typically less than 15 minutes) to monitor progress and troubleshoot any potential barriers to engagement with the walking program. Due to the COVID pandemic, most participants received the entire intervention via telehealth, using video consultations and phone calls.

The program was designed to be manageable, with a target of five walks per week of roughly 30 minutes daily by the end of the six-month program. Participants were also encouraged to continue walking independently after the program.

Importantly, the walking program was combined with education provided by the physiotherapists during the six sessions. This education aimed to give people a better understanding of pain, reduce fear associated with exercise and movement, and give people the confidence to self-manage any minor recurrences if they occurred.

People in the control group received no preventative treatment or education. This reflects whattypically occursafter people recover from an episode of low back pain and are discharged from care.

What the results showed

We monitored the participants monthly from the time they were enrolled in the study, for up to three years, to collect information about any new recurrences of low back pain they may have experienced. We also asked participants to report on any costs related to their back pain, including time off work and the use of health-care services.

The intervention reduced the risk of a recurrence of low back pain that limited daily activity by 28%, while the recurrence of low back pain leading participants to seek care from a health professional decreased by 43%.

Participants who received the intervention had a longer average period before they had a recurrence, with a median of 208 days pain-free, compared to 112 days in the control group.

Overall, we also found this intervention to be cost-effective. The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group.

This trial, like all studies, had some limitations to consider. Although we tried to recruit a wide sample, we found that most participants were female, aged between 43 and 66, and were generally well educated. This may limit the extent to which we can generalise our findings.

Also, in this trial, we used physiotherapists who were up-skilled in health coaching. So we don’t know whether the intervention would achieve the same impact if it were to be delivered by other clinicians.

Walking has multiple benefits

We’ve all heard the saying that “prevention is better than a cure” – and it’s true. But this approach has been largely neglected when it comes to low back pain. Almost allprevious studieshave focused on treating episodes of pain, not preventing future back pain.

A limited number ofsmall studieshave shown that exercise and education can help prevent low back pain. However, most of these studies focused on exercises that are not accessible to everyone due to factors such as high cost, complexity, and the need for supervision from health-care or fitness professionals.

On the other hand, walking is a free, accessible way to exercise, including for people in rural and remote areas with limited access to health care.

Walking also delivers many otherhealth benefits, including better heart health, improved mood and sleep quality, and reduced risk of several chronic diseases.

While walking is not everyone’s favourite form of exercise, the intervention was well-received by most people in our study. Participantsreportedthat the additional general health benefits contributed to their ongoing motivation to continue the walking program independently.

Why is walking helpful for low back pain?

We don’t know exactly why walking is effective for preventing back pain, butpossible reasonscould include the combination of gentle movements, loading and strengthening of the spinal structures and muscles. It also could be related to relaxation and stress relief, and the release of “feel-good” endorphins, whichblock pain signalsbetween your body and brain – essentially turning down the dial on pain.

It’s possible that other accessible and low-cost forms of exercise, such as swimming, may also be effective in preventing back pain, but surprisingly,no studieshave investigated this.

Preventing low back pain is not easy. But these findings give us hope that we are getting closer to a solution, one step at a time.

The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.

© The Conversation

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Walking can prevent lower back pain, new study shows (3)

Walking can prevent lower back pain, new study shows (4)

DenTok2009

I've been walking with lower back pain for a while. Haven't been to a doctor, but just self-diagnosing that if I lose the weight that I've packed on, I will lose the lower back pain. I used to go for a walk, rain or shine. Nowadays, I blame the weather for not going out for a walk.

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Walking can prevent lower back pain, new study shows (5)

Walking can prevent lower back pain, new study shows (6)

wallace

I have had lower back pain for more than 40 years. Sometimes more and sometimes less. I walk and can't say it reduces back pain. Probably swimming, and gym workouts. I use Electrotherapy when the pain increases but I haven't used it in a while. Visits to a good osteopath help. A decrease in overweight is always good.

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Walking can prevent lower back pain, new study shows (7)

Walking can prevent lower back pain, new study shows (8)

falseflagsteve

Dentok

Good luck with your weight lose

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Walking can prevent lower back pain, new study shows (9)

Walking can prevent lower back pain, new study shows (10)

Bad Haircut

I've had lower back pain for decades even with regular strenuous walking. The a few months ago changed my diet and the pain eased off over about 2-3 weeks and has gone, so I put it down to eliminating the source of the inflammation.

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Walking can prevent lower back pain, new study shows (11)

Walking can prevent lower back pain, new study shows (12)

wallace

My lower back pain is not about diet. I have a six vertebrae lower lumbar which I also injured moving a heavy object.

Different folks, different strokes.

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Walking can prevent lower back pain, new study shows (13)

Walking can prevent lower back pain, new study shows (14)

Bad Haircut

wallaceToday01:48 pm JST

My lower back pain is not about diet. I have a six vertebrae lower lumbar which I also injured moving a heavy object.

Different folks, different strokes.

Indeed, that may be the case. I've had my back x-rayed several times and no doctor could find any cause to the pain, just advising me not to lift anything too heavy...

A few years ago just before I went skiing, my back was playing up quite a bit, so as an experiment I knocked off more smoked salmon than I thought was humanly possible at the hotel buffet to see whether the omega-3 would help. Whatever it was, the pain had evaporated overnight and I was able to hit the snow pain free the next day, keeping up the high dose of salmon each night and morning while there. So I figured that salmon was suppressing inflammation but had no idea what was causing the inflammation in the first place. After changing my diet, I've concluded that the most likely culprit was carbs, mainly sugar, bread, rice and starchy vegetables. This is because even though I'd quit sugar a few years ago I was still eating plenty of wheat products, rice and potatoes etc and the pain was still there.

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Walking can prevent lower back pain, new study shows (15)

Walking can prevent lower back pain, new study shows (16)

Speed

This education aimed to...reduce fear associated with exercise and movement...

Imagine humans having come to this.

Bad Haircut: I've concluded that the most likely culprit was carbs, mainly sugar, bread, rice and starchy vegetables.

Absolutely. Carbs and sugar are very inflammatory. I've found a lot less pain, not only my lower back, but in other parts of my body, like my shoulder. Salmon is a fatty fish with lots of nutritional benefits, and like you said, plenty of Omega 3 fatty acids.

I now walk daily for about twenty to thirty minutes and can feel my lower back loosening up in the first few minutes of my walk. I always feel refreshed both mentally and physically after each time.

I've always been quite athletic and played a lot of "hard" sports, but just walking has been very therapeutic and healing.

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Walking can prevent lower back pain, new study shows (17)

Walking can prevent lower back pain, new study shows (18)

DenTok2009

Hey Steve, (thumbs up!) thanks. I'm kinda sorta doing keto and intermittent fasting. I lost weight during the lockdown. Then I started putting on the weight around March and put my head in the sand for a couple of months.

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Walking can prevent lower back pain, new study shows (19)

Walking can prevent lower back pain, new study shows (20)

virusrex

Imagine humans having come to this.

There is nothing strange about it, people get a very painful experience that is very frequently related to physical activity and is also very likely to happen again, people understandably can get the wrong idea that excercise and movement can increase the chances of this happening again.

Absolutely. Carbs and sugar are very inflammatory

Not all carbohydrates are the same, and eating fruits is much less inflammatory than refined sugar, on the other hand meat and trans fats are also considered very inflammatory, so people can have elevated markers even without consuming sugar.

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Walking can prevent lower back pain, new study shows (21)

Walking can prevent lower back pain, new study shows (22)

Pukey2

I gave up cycling and now just walk everywhere. At least an hour a day.

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Walking can prevent lower back pain, new study shows (23)

Walking can prevent lower back pain, new study shows (24)

Bad Haircut

virusrexJune 2805:16 pm JST

Imagine humans having come to this.

There is nothing strange about it, people get a very painful experience that is very frequently related to physical activity and is also very likely to happen again, people understandably can get the wrong idea that excercise and movement can increase the chances of this happening again.

Absolutely. Carbs and sugar are very inflammatory

Not all carbohydrates are the same, and eating fruits is much less inflammatory than refined sugar, on the other hand meat and trans fats are also considered very inflammatory, so people can have elevated markers even without consuming sugar.

Wrong again on all counts.

-1(+0/-1)

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Walking can prevent lower back pain, new study shows (2024)
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