Avoid low back pain with this simple lifestyle adjustment

Research suggests that low back pain currently impacts over 619 million people globally, with projections showing this number could rise to 843 million by 2050.

Sadly, around 70% of individuals who recover from low back pain experience a recurrence within a year. Beyond the pain and time lost at work, treatment often involves physical therapy, education, and exercises like Pilates, which may require extra costs or specialized gear.

However, a new clinical trial has found an easy, cost-free method to reduce low back pain for some time.

Participants in the study who walked regularly after experiencing at least one episode of low back pain were pain-free for nearly twice as long as those who did not engage in regular walking.

According to senior author Mark Hancock, a physiotherapy professor at Macquarie University in Sydney, "The group that participated in the intervention experienced fewer instances of pain limiting their activities compared to the control group, and they had a longer average time before experiencing a recurrence—208 days versus 112 days."

Hancock also highlighted, "Walking is an inexpensive, easy-to-do exercise that almost anyone can participate in, regardless of age, location, or economic background."

Walking for at least 30 minutes

The study, published in The Lancet on Wednesday, tracked 701 Australian adults, mostly women in their 50s, who had recently recovered from an episode of low back pain that had interfered with their daily activities. Participants were randomly assigned to either a control group or a group with a tailored walking and education program.

Participants in the intervention group were encouraged to gradually increase their walking to 30 minutes, five times a week, over six months, at a pace suited to their age, fitness level, and preferences. Jogging was also permitted.

After three months, most participants were walking three to five days a week, averaging 130 minutes total, Hancock shared with Dinogo via email.

Participants were instructed to wear pedometers to monitor their daily steps and keep a walking log. At the three-month mark, they also wore an accelerometer to objectively track their step count and the amount of brisk walking or other physical activity.

The program also offered six physiotherapist-led education sessions over six months, a more affordable option compared to traditional treatment, according to Hancock.

Hancock explained, "We provided 3 standard physiotherapist sessions and 3 brief phone check-ins. In contrast, earlier studies on back pain prevention typically included around 20 group sessions."

We also covered simple methods to lower the risk of back pain recurrence and provided guidance on managing minor flare-ups. The educational sessions were integrated with the walking program.

Affordable intervention

In addition to extending pain-free periods for participants, the walking program cut the time taken off work and medical visits by 50%, according to lead author Natasha Pocovi, a postdoctoral fellow at Macquarie.

Pocovi explained, "Previous exercise-based interventions to prevent back pain have generally been group-oriented, requiring close clinical supervision and costly equipment, making them less accessible to most patients."

She added, "Our study demonstrates that this effective and accessible exercise method could be implemented on a much larger scale than other exercise options."

Due to the design of the study, it was not possible to pinpoint whether the benefits were mainly due to walking or the educational sessions led by physiotherapists, Hancock explained.

"We believe the two components likely work together, with education helping to reduce the fear of movement, while the walking program and health coaching led to behavior changes," he added.

However, A. Lynn Millar, a retired physical therapist and former professor at Winston-Salem State University in North Carolina, suggested that since the intervention resembled behavioral coaching rather than physical therapy, walking might have been the main factor behind the improvement. Millar was not involved in the study.

"This is crucial, as many studies have shown that pain responses are partially behavioral," Millar said in an email. "Given that the coaching was brief, it's likely that walking played the major role in the long-term results."

The benefits of walking for the body

Why is walking so effective for relieving lower back pain? For starters, exercise benefits the entire body.

"Firstly, walking reduces sitting time, which is not ideal for the back," said Millar. "Secondly, walking boosts overall circulation, including blood flow to the back muscles that support the body during movement. Joint movement also helps circulate joint fluids, which may benefit the spine's joints as well."

Experts say walking enhances metabolism and burns more calories. Reducing body weight lessens the strain on the back and legs, improving spinal health. A brisk walk also strengthens the core and leg muscles, improving posture and offering better spinal support.

Walking boosts muscle endurance, making muscles less prone to fatigue and injury. As a weight-bearing exercise, walking increases bone density, reducing the risk of injury while encouraging the release of endorphins, the body’s natural pain-relieving hormones that also reduce stress.

When beginning a walking routine, it’s essential to wear proper shoes and arch supports. Potential issues can be mitigated with additional exercises like resistance training and stretching, according to Millar.

"I believe it’s important to vary your pace and distance throughout the week. Some problems arise when people increase their intensity too quickly and ignore early signs of discomfort," Millar explained.

"I’ve also encountered individuals wearing shoes with poor support, or shoes so worn out that the support was no longer effective," she added.

If you experience back pain while walking, switching to gentler activities like cycling or swimming may be necessary, Millar advised. Taking a day or two off from walking and focusing on back exercises and stretching can also be beneficial.