How Walking Helps To Reduce Lower Back Pain

When lower back pain strikes, lounging on the sofa and indulging in a television marathon might seem like the best recourse. It’s only natural to shy away from any activity that could potentially exacerbate the pain.

But rather than kicking back, consider stepping into some comfortable sneakers and embark on a soothing walk. This simple activity could be just what you need to mitigate the discomfort in your back.

A groundbreaking study named the WalkBack trial, released in June 2024 and published in The Lancet, involved over 3,000 individuals recuperating from lower back pain. The study revealed that participants who joined a structured walking regimen—complete with learning sessions led by a physical therapist—drastically reduced their chances of suffering from recurring back pain compared to a control group that did not engage in the walking program.

Walking’s power to mollify chronic lower back pain could be major. As reported by the Centers for Disease Control and Prevention (CDC), chronic lower back pain is a public health conundrum that impacts as many as 40 percent of Americans, which includes approximately one in three adults between the ages of 18 to 29.

Intense, enduring back pain is the primary cause of work-related disability and a significant factor contributing to missed work days and medical appointments, as documented by the 2019 U.S. National Health Interview Survey. Individuals suffering from back pain often skip social engagements and are prone to experience feelings of melancholy more so than those without back pain, as indicated by the Georgetown University Health Policy Institute.

Yet, the strategy of adopting routine walks as a method to preempt the recurrent nature of lower back pain—which affects 70 percent of patients within a year post-recovery—has seldom been scrutinized, according to Natasha Pocovi, PhD, MPT, a postdoctoral investigator at Macquarie University in Sydney, Australia, and co-author of the WalkBack study.

“In the context of research and clinical settings, the focal point is predominantly on treating low back pain, with almost no attention given to prevention,” Dr. Pocovi states. “Given the tendency for low back pain to relapse, prevention is crucially important—and I believe this is an area where we can certainly improve.”

Keep reading to discover more on the virtues of walking for back pain and how it could potentially benefit you.

The Benefits of Walking for Alleviating Back Pain

Even if you’re inclined to minimize movement during bouts of back pain, avoiding activity is perhaps one of the least favorable choices, notes Colleen Louw, MPT, an advocate for the American Physical Therapy Association as well as program director for the Therapeutic Pain Specialist Certification at Evidence In Motion, a learning institution for medical professionals.

“A sedentary lifestyle can lead to a cascade of complications,” Louw remarks. “Remaining static for prolonged periods puts strain on certain tissues, making them susceptible to harm. Strained tissues are at a higher risk for injuries.”

In contrast, engaging in physical activity like walking has positive implications for overall well-being and recovery.

“Being active catalyzes blood circulation to the tissues and boosts the oxygen supply necessary for healing,” Louw explains. “Not only does activity deliver essential nutrients to the tissues, but it also engenders the release of endorphins—these ‘feel-good’ compounds improve our mood. The gist is simple: the more active you are, the better you feel.”

Within the 12- to 36-month observation phase of the WalkBack trial, participants in the walking procedure exhibited a 28 percent decrease in the likelihood of recurrent back pain impeding their activities, and a 43 percent reduction in the need for medical intervention due to back pain compared to those not in the walking program.

For those troubled by lower back pain, walking is an excellent choice given its low impact nature, easing worries about pain or re-injury, comments Dr. Pocovi. A subsidiary study in 2023 within the Journal of Physiotherapy, to which Dr. Pocovi contributed, found that individuals with lower back pain were wary of engaging in high-impact exercises but deemed walking to be a secure form of exercise.

“People who experience recurrent back pain often harbor anxiety and reluctance towards exercise, especially types that are considered high impact or demanding,” Dr. Pocovi notes. “That’s why walking appealed to our research participants and was generally regarded as a safe pursuit.”

The WalkBack trial pointed out that most exercise interventions previously researched for lower back pain tended to involve specialized equipment, professional oversight, and significant expense. Walking, meanwhile, calls for nothing more than a reliable pair of shoes and can be performed just about anywhere.

“In terms of cost-effectiveness, walking eliminates the need for equipment and can typically be done without any supervision, providing those with recurring low back pain easy and affordable access to this form of exercise,” expresses Dr. Pocovi.

Although the physical act of walking was crucial to alleviating back pain, the educational and coaching sessions with a physical therapist, as provided in the WalkBack trial’s walking program, also played an integral part in the outcomes. The guidance and reassurance supplied by physical therapists were empowering, helping participants to self-direct their pain management and decrease their dependence on medical practitioners, Dr. Pocovi elucidates.

“Altering physical activity habits, or the absence thereof, is challenging,” she says. “Involvement from clinicians [physical therapists] introduced accountability for those in the walking program, with injury monitoring, prudent advancement of the walking regimen, and dissemination of educational content—all believed to be pivotal to the program’s triumph.”

Physical therapists are not always immediately linked with walking regimens, but Louw contends they play a pivotal role, offering everything from assessments to ongoing encouragement and strategies for preventing injuries. According to the Journal of Physiotherapy study, individuals who had recently gotten past low back pain had positive reflections on the prescribed walking program facilitated by physiotherapists—citing reasons like accountability and motivation.

“Fear can render people immobile. They dread that any movement will cause injury,” Louw highlights. “This is the juncture where we educate them about physical occurrences, that they might encounter soreness yet moving is still secure and permissible despite discomfort. As professionals with extensive training and education, we thrive in nurturing enduring relationships with clients.”

What Amount of Walking Is Needed to See Improvement?

The participants of the WalkBack trial’s walking group gradually reached an average of three to five days of walking each week, amassing a total of about 130 minutes weekly by the third month of the experiment.

“This appears to be a practical recommendation based on our findings,” asserts Dr. Pocovi.

Louw notes these figures closely align with the Physical Activity Guidelines endorsed by the American College of Sports Medicine, which advises a half-hour of moderate-intensity exercise a minimum of five days per week. However, individuals will need to build up gradually to such levels of walking—a process in which a PT can guide you to prevent injuries, she stresses.

“Physical therapists are there to aid you in progressively increasing your level of activity,” Louw comments. “Some might feel robust and opt for a three-mile march, only to end up bedridden. What we’re aiming for is a steady increase in activity.”

What Happens When You Stop Walking?

If using walking as a method to prevent recurrence of back pain proves effective, a natural follow-up inquiry would be whether ceasing to walk could lead to the pain’s return. There is a significant likelihood of this happening, according to statements from both Louw and Dr. Pocovi.

“To achieve enduring results from any intervention, ongoing or sustained participation is generally required. We anticipate that the same holds true for walking,” comments Dr. Pocovi.

Participants in the limited-scale Journal of Physiotherapy study expressed that any lapse in their walking routine could trigger minor discomfort, prompting them to recommit to the walking regimen. This underscores the importance of maintaining regular activity to continue to reap benefits,” Dr. Pocovi elaborates.

Essentially, if you’ve discovered that walking alleviates your back pain, it’s advisable to stick with it.

“It’s a simple equation: Movement minimizes pain, but if you stop moving and the pain resurfaces, it’s clear that the movement must persist,” Louw explains.

Walking Safely With Lower Back Pain

Though walking is typically a safe exercise to undertake, those with certain health conditions—especially those related to heart health, balance, or the elderly—should seek approval from their healthcare providers before embarking on a walking regimen, recommends Louw.

Physiotherapists are prepared to conduct thorough medical evaluations, collaborate with doctors, and guide individuals to gradually and safely begin a walking practice, she continues.

It’s crucial to gradually increase your walking routine to prevent injuries. Additionally, consider the climate if you’re walking outdoors, Louw points out.

“Particularly for seniors, the weather can be a constraint. In snowy climates, it may be necessary to opt for indoor options, like walking on a treadmill at a fitness center for part of the year,” she mentions.

Experiencing pain during your walk doesn’t immediately signal the need to give up on walking entirely. However, scaling back or seeking further evaluation might be necessary if discomfort persists, Louw suggests.

“Pay attention to what your body tells you,” she advises. “If you start to feel back pain, it might indicate that you’ve walked enough for that day. However, this doesn’t mean you should completely stop unless medically advised to do so. The [WalkBack] study has shown that walking does not exacerbate the situation. It is vital to remember that from a physiological standpoint, being sedentary puts more strain on the tissues than staying active.”