Regular walking can reduce recurrence of lower back pain

An Australian clinical trial has found adults with a history of lower back pain went nearly twice as long without recurrence of their back pain – as long as they walked regularly.

Lower back pain is the leading cause of disability worldwide. It was estimated to affect 619 million people globally in 2020 and this is projected to rise to 843 million by 2050.

The combination of exercise and education has been shown to prevent the recurrence of lower back pain, however, not all forms of exercise are accessible or affordable to many people.

The new research aimed to determine whether an individualised walking program and 6 physiotherapist-guided education sessions over 6 months could be effective intervention.

The trial involved 701 adults who had recently recovered from an episode of lower back pain. They were randomly allocated to the intervention group or to a control group and followed up by researchers for between 1 and 3 years.

“The intervention group had fewer occurrences of activity limiting pain compared to the control group, and a longer average period before they had a recurrence, with a median of 208 days compared to 112 days,” says Mark Hancock, a professor of physiotherapy at Macquarie University in Australia, and senior author of the paper in the Lancet.

“Walking is a low-cost, widely accessible and simple exercise that almost anyone can engage in, regardless of geographic location, age or socio-economic status.

“We don’t know exactly why walking is so good for preventing back pain, but it is likely to include the combination of the gentle oscillatory movements, loading and strengthening the spinal structures and muscles, relaxation and stress relief, and release of ‘feel-good’ endorphins.

“And of course, we also know that walking comes with many other health benefits, including cardiovascular health, bone density, healthy weight, and improved mental health.”

Lead author Dr Natasha Pocovi from Macquarie University says that, in addition to providing participants with longer pain-free periods, the program was very cost-effective.

“It not only improved people’s quality of life, but it reduced their need both to seek healthcare support and the amount of time taken off work by approximately half,” says Pocovi.

“The exercise-based interventions to prevent back pain that have been explored previously are typically group-based and need close clinical supervision and expensive equipment, so they are much less accessible to the majority of patients.

“Our study has shown that this effective and accessible means of exercise has the potential to be successfully implemented at a much larger scale than other forms of exercise.”

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