For adults with a history of lower back pain, walking may provide a simple remedy: Researchers have found that patients who followed an easy walking program were able to go nearly twice as long without their backache returning as others not in the program.

“We were surprised at just how much the intervention also could impact people’s lives aside from improving their low back pain,” Dr. Pocovi adds. “We had patients who reported improved sleep, mood, positive lifestyle changes, and improved management of other chronic health conditions.”

Back Pain Recurs Within a Year in 7 out of Every 10 People

But many people can’t get effective treatment because of the high cost and the need for professional supervision, according to Pocovi and her study coauthors.

New Study Followed Adults With Back Pain for Up to 3 Years

For this clinical trial, the research team enlisted 701 adults who had recently recovered from an episode of back pain. Just over half were assigned to an intervention group and received an individualized walking program with six physiotherapist-guided education sessions; the remainder were placed in a control group without a specific instruction or treatment.

At the study start, both the intervention and control groups reported walking about 70 minutes per week on average. The intervention group was asked to follow a regular regimen with a goal in mind: By six months, they should be walking five times per week for at least 30 minutes per day. Most got close to that target after three months.

The education sessions for the intervention group aimed to provide a basic understanding of pain, reduce fear associated with exercise, and build confidence to manage pain. The physiotherapists also discussed simple strategies to reduce the risk of a recurrence of low back pain and gave instructions on how to self-manage any minor recurrences.

The researchers followed all subjects for one to three years to see if their back pain recurred and to measure other health and quality-of-life factors.

Cutting the Risk of Pain Recurrence

Participants in the walking program reduced the risk of low back pain recurrence that limited daily activity by 28 percent. Their risk of needing care from a health professional because of recurrence decreased by 43 percent compared with the no-intervention control group.

“Particularly in more sedentary individuals, a dedicated walking program may help address deconditioning that can occur with movement avoidance and buffer against future pain episodes,” says Beth Darnall, PhD, professor of anesthesiology, perioperative, and pain medicine with the Stanford Pain Management Center in Redwood City, California, who was not involved in the research.

The analysis also highlighted that a simple walking program improved people’s quality of life and reduced their need both to seek healthcare support and the amount of time taken off work.

Why Walking Helps With Pain Relief

“Exercise can help reduce stress by releasing [the feel-good hormones] serotonin and endorphins to mitigate how we experience pain,” says Dr. Alm, who was not involved in the research. “Another physiologic benefit in walking is that it increases circulation, which improves blood flow pumping nutrients into soft tissue structures such as muscles, ligaments, and tendons.”

Most Study Participants Were Women in Their 40s, 50s, and 60s

The study authors recognized that the results were limited in that most participants were female (81 percent) between ages 43 and 66. Most also had many previous episodes of low back pain. These are all factors that need to be considered when looking at the findings in relation to the general population.

Plus, “What this study does not account for is whether the walking group engaged in other activities such as flexibility programs or core strengthening, activities that are also known to be helpful in strengthening the back and reducing low back pain,” says James Gladstone, MD, chief of the division of sports medicine for the Mount Sinai Health System in New York City, who was not part of the research team.

With Back Pain, Prevention Is Vital

When it comes to back pain, Pocovi and her research team believe that too much attention has been placed on treating episodes rather than preventing them in the first place. They anticipate that this study may shift the focus more to prevention.

Alm definitely suggests that back pain sufferers make walking part of their daily routine.

“The best part of walking is that it is free, easy to do, very accessible, and can be adapted to almost all levels of physical ability,” he says.