(CNN) — Low back pain affects at least 619 million people worldwide, and this number is expected to increase to 843 million people by 2050, According to researchers’ estimates.
Unfortunately, nearly 70% of people who recover from an episode of low back pain have a recurrence within the yearexperts say. In addition to acute physical discomfort and lost work time, treatment often requires education, physical therapy and exercises such as Pilates which may require fees or specialized equipment.
Yet there is a simple, free way to prevent lower back pain, at least for a while, according to a new randomized clinical trial.
People in the study who walked regularly after having at least one episode of low back pain remained pain-free almost twice as long as those who did not.
“The intervention group had fewer occurrences of activity-limiting pain compared with the control group, and a longer average time to recurrence, with a median of 208 days compared with 112 days,” said lead author Mark Hancock, professor of physiotherapy at Macquarie University in Sydney.
“Walk “It is a low-cost, widely accessible and simple exercise that almost anyone can participate in, regardless of their geographic location, age or socio-economic status,” Hancock said in a statement.
Walk for at least 30 minutes
The study, published Wednesday in the journal The LancetThe study followed 701 Australian adults, mostly women in their 50s, who had recently recovered from an episode of low back pain that had disrupted their ability to perform daily activities. Each person was randomly assigned to a control group with no intervention or a tailored walking and education program.
Participants in the intervention group were asked to walk for up to 30 minutes five times a week over a six-month period, at paces appropriate to age, physical ability and individual preferences. Jogging was also permitted.
“After three months, most people who participated were walking three to five days a week for an average of 130 minutes total,” Hancock told CNN via email.
Participants were asked to wear pedometers to track their daily steps and keep a walking log. After three months in the program, they also wore an accelerometer that objectively measured the number of daily steps and the amount of brisk walking or other physical activity.
The program also offered six physiotherapist-led training sessions over six months, a more cost-effective model than traditional treatment, Hancock said.
“We included 3 standard sessions with a physical therapist and 3 brief telephone interviews,” he said in an email. “In the few previous studies of exercise programs for back pain prevention, the intervention included about 20 group classes.”
“We also discussed simple strategies to reduce the risk of low back pain recurrence and instructions on how to self-manage any minor recurrences. Education was incorporated into the same sessions as the walking prescription.”
Cost-effective intervention
In addition to giving participants longer periods of pain-free time, the walking program halved time away from work and medical visits, said Natasha Pocovi, lead author of the study and a postdoctoral researcher at Macquarie.
“Exercise-based interventions to prevent back pain that have been previously explored are typically group-based and require close clinical supervision and expensive equipment, making them much less accessible to the majority of patients,” Pocovi said in a statement.
“Our study showed that this effective and accessible form of exercise has the potential to be successfully implemented on a much larger scale than other forms of exercise.”
Because of the study design, it was not possible to determine how much of the benefits were due to the walking or the educational program delivered by physical therapists, Hancock said.
“We believe it is likely that the two components complement each other, with education helping to overcome avoidance and fear of movement, while the health and walking coaching programme led to behaviour change,” he said.
However, because the intervention appears to be behavioral coaching and not true physical therapy, walking may well have been the main reason for the improvement, said A. Lynn Millar, a retired physical therapist and former professor at Winston-Salem State University in North Carolina. She was not involved in the study.
“This is important because many studies have shown that the response to pain is partly a behavioral response,” Millar said in an email. “The coaching was time-limited, suggesting that the primary intervention, walking, was the major contributor to the long-term response.”
The benefits of walking on the body
Why is walking so beneficial for lower back pain? First of all, exercise is beneficial for all parts of the body.
“First of all, the person is sitting less, and sitting is not the best posture for the back,” Millar said. “Second, walking improves overall circulation and improves blood flow to the back muscles that are actively supporting the person during movement. Moving a joint also helps circulate joint fluids, which can benefit the joints of the spine.”
Walking improves metabolism and the amount of calories burnedexperts say. Lower weight can ease the strain on your back and legs, ensuring better spinal health. Taking a brisk walk also improves the strength of the core muscles around your spine and in your legs, which can improve posture and provide better support for your spine.
Walking also increases muscular endurancewhich makes muscles less susceptible to fatigue and injury. Weight-bearing exercises like walking increase bone density, protecting against injury while stimulating the release of endorphins, the body’s natural feel-good hormones that reduce pain and stress.
When starting a walking program, good shoes and arch supports are necessary, and potential problems can be offset with exercise programs such as resistance training and stretching, Millar said.
“I also think it’s important to vary paces and distances throughout the week. Some problems are caused by progressing too quickly and not paying attention to initial pain,” she said.
“I’ve also seen people walking in shoes that didn’t provide good support, or were so worn that the support was gone,” she added.
If you have “back pain” while walking, you may need to modify your activity, such as biking or swimming, Millar said. Taking a day or two off and doing some back exercises and stretches can also help.
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