Walking can be a powerful remedy for back pain: Study

NEW YORK – Doctors and physical therapists have long incorporated aerobic exercise into treatment programmes for lower-back pain. Movement can simultaneously ease lower-back pain and also strengthen the muscles that support your back.

Still, many people with back pain can be hesitant to exercise.

A new study, published recently in the peer-reviewed medical journal The Lancet, offers more evidence on the power of movement.

The study found that a regular walking routine can be very effective in preventing the recurrence of back pain. It focused on adults with a history of lower-back pain. Those who walked regularly went nearly twice as long without their back pain coming back compared with the control group.

The findings are in line with a large body of existing research that has established an association between physical activity and better outcomes for back pain. A 2019 systematic review found that physical activity lowered the prevalence of back pain. And a 2017 study found that yoga worked as well as physical therapy for relieving back pain.

The new study builds on this research by following patients outside a tightly controlled clinical setting.

Professor of physiotherapy Mark Hancock at Macquarie University in Australia, who is a senior author of the study, sought to evaluate the effectiveness of a less expensive intervention that could be easier for many people to access than in-clinic treatment.

He and a team of researchers targeted a relatively sedentary sample group.

They collected data on 701 adults who had recently recovered from an episode of lower-back pain. They were randomly split in two groups. One group received an individualised walking and education programme, facilitated by a physiotherapist over six sessions in a six-month period. The other group did not receive any intervention.

The researchers followed both groups for the next one to three years.

The goal for each person in the walking group was to walk five times a week for at least 30 minutes daily, but the programme was highly personalised based on age, body mass index, current activity level, time constraints and personal goals.

Participants in the walking group also received an education programme to help them better understand and respond to their pain. When patients had an uptick of lower-back pain, they were encouraged to continue walking, but adjust their speed and distance as needed.

Prof Hancock said that when many people experience increased pain, they often feel especially protective of their back and avoid movement.

“The education changed the way that they thought about that and got them being more active – and remaining active when they had some back pain,” he said.

The new findings also echo the conclusions of a 2020 meta-analysis of 25 studies on lower-back-pain prevention, of which Prof Hancock was co-author. In the meta-analysis, researchers found that regular exercise, combined with physical education, was the most effective way to prevent lower-back pain from recurring.

Although there are many different causes of lower-back pain, often the root cause is having a “weak base of support”, said Dr Hamza Khalid, a physician at the Cleveland Clinic Center for Spine Health. Walking can help strengthen the muscle groups that help stabilise the spine, primarily the core muscles. Core weakness can lead to fatigue, spine misalignment and pain, he said.

Almost seven in 10 people who recover from an episode of lower-back pain will experience a recurrence within the following year, according to Prof Hancock’s research.

“Exercise is like medicine,” Dr Khalid said, while also emphasising that it is no magic pill. If your back pain is chronic or complex, your doctor or physical therapist can help you tailor an exercise programme to your specific needs.

Still, moving your body is likely to help. At this point, Prof Hancock said, “the evidence is pretty overwhelming”. NYTIMES