Walking three times a week to relieve back pain almost halves the risk of recurrence, according to the first study of its kind.
About 800 million people worldwide have low back pain, and seven out of 10 who recover experience a flare-up within a year.
Researchers said the findings, published in the Lancetcan show walking have a “profound impact” on the leading cause of disability worldwide.
“You don’t have to walk 5 or 10 km every day to get these benefits,” says Mark Hancock, the study’s senior author and a professor of physical therapy at Macquarie University in Australia.
“The important thing to remember is to start with short walks and then gradually increase the distance and intensity as your fitness increases. Walking is a low-cost, widely accessible and simple exercise that almost anyone can participate in, regardless of geographic location, age or socio-economic status.”
Hancock said people who walked three to five times a week, for an average of 130 minutes a week, remained pain-free nearly twice as long compared to those who received no treatment.
Taking regular steps also improved their quality of life, and the time they had to take off work almost halved, he added.
In the world’s first randomized controlled trial assessing the effectiveness of walking in preventing recurrence of low back pain, scientists followed 701 adults for three years who had recently had an episode of low back pain.
Half were assigned to a walking scheme and education sessions from a physiotherapist, while the rest were assigned to a control group and were not provided with any specific intervention.
“The intervention group had fewer instances of activity-limiting pain compared to the control group, and a longer average time before having a recurrence, with a median of 208 days compared to 112 days,” Hancock said. “The risk of having a recurrence requiring care was almost halved in those in the intervention group.
“We gave them a rough guide to build up to 30 minutes, five times a week, over a period of six months. After three months, most of the people who participated were walking three to five days a week for an average total of 130 minutes.”
He added: “We don’t know exactly why walking is so good at preventing back pain, but it probably involves the combination of the gentle oscillatory movements, loading and strengthening of the spinal structures and muscles, relaxation and stress relief, and release. ‘feel good’ endorphins.
“And of course, we also know that walking has many other health benefits, including cardiovascular health, bone density, healthy weight and improved mental health.”
Rory Fagan joined the trial in 2021, seeking relief from a back injury sustained playing rugby in his 20s. In the three years since he’s been walking three times a week, he’s had only one episode of debilitating pain.
“The thing with back pain is most people’s instinct is to do nothing because even taking a step can send a jolt or spasm up your back,” he said. “Exercise goes a long way to reducing pain, so if you have a flare-up, keep doing what you can.”
Prof Kamila Hawthorne, the chair of the Royal College of GPs in the UK, welcomed the research and said it was “important” that the results were “taken on board as clinical guidance is developed and updated”.
Dr Athalie Redwood-Brown, a senior lecturer in physical activity and health at Nottingham Trent University, said the findings had “the potential to transform preventive care, and provide a scalable solution that could benefit millions”.
