Study Links Walking Habit to Decreased Back Pain Incidence

Nearly 7 in 10 who get an episode of low back pain will have another within 12 months. But those who engaged in this were pain-free for nearly twice as long.

STORY AT-A-GLANCE

• Walking is an effective, low-cost intervention for preventing and managing low back pain. Studies show it can significantly extend pain-free periods and reduce recurrence risk by up to 43%

• Regular walking is as beneficial as other forms of exercise for chronic low back pain, improving pain levels, disability, quality of life, and fear avoidance

• Walking offers numerous health benefits beyond pain relief, including improved cardiovascular health, better sleep, increased resilience, and potential reversal of cellular aging mechanisms

• Moderate exercise like walking is more beneficial for longevity than vigorous exercise. Aiming for 7,000 to 12,000 steps daily provides optimal health benefits without risk of overexertion

• Strategies to enhance walking routines include using weighted vests, Nordic walking poles, walking outdoors in nature, walking with friends, and combining walks with purposeful activities like learning or brainstorming

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There’s good news for the 619 million people suffering from low back pain worldwide.^¹ Walking, a simple, free exercise, may help prevent back pain and keep it away longer.² Effective interventions like this can significantly improve quality of life, considering that nearly 7 in 10 people who experience an episode of low back pain will have another within 12 months.³

Those who engaged in the walking program, however, were pain free for nearly twice as long as those who didn’t walk,⁴ adding even more reason to make walking a regular part of your routine.

"Walking is a low-cost, widely accessible and simple exercise that almost anyone can engage in, regardless of geographic location, age or socio-economic status," said study author Mark Hancock with Macquarie University in Sydney, Australia.⁵

Five Walks a Week Kept Back Pain Away Longer

The study, called WalkBack, revealed that a simple walking program, combined with some education, could significantly reduce the chances of back pain coming back. It involved 701 adults who had recently recovered from a bout of low back pain. Half of the participants were given a personalized walking program and six sessions with a physiotherapist over six months, while the other half went about their usual routines.

Those in the walking group had a target of five walks per week for about 30 minutes daily — and they were encouraged to continue walking when the program ended. The walking group saw much better results. On average, they went about 208 days before experiencing another episode of back pain that limited their activities. The non-walking group, however, only made it 112 days before their back pain came back.

Further, walking reduced the risk of low back pain recurrence that limited daily activity by 28%, while risk of low back pain recurrence that caused participants to seek medical care decreased by 43%.⁶

On a societal level, the researchers also looked at the cost-effectiveness of this approach. For every quality year of life gained, it only cost about AU$7,802, or $5,257 in U.S. dollars. In the world of health care, that's considered quite cost-effective. "The biggest savings came from less work absenteeism and less health service use (such as physiotherapy and massage) among the intervention group," the researchers explained.⁷

In fact, the walkers also reported that additional general health benefits they experienced along with back pain relief motivated them to keep walking.⁸ Writing in The Lancet, the researchers added, "This accessible, scalable, and safe intervention could affect how low back pain is managed."⁹

Walking Works as Well as Other Forms of Exercise to Relieve Back Pain

Other research also supports the effectiveness of walking as a treatment for chronic low back pain. A comprehensive meta-analysis published in Disability and Rehabilitation examined five randomized controlled trials comparing walking interventions to other forms of physical exercise.¹⁰

Their findings reveal that walking is just as effective as other exercise types in reducing pain, improving disability and quality of life, and decreasing fear-avoidance in individuals with chronic low back pain. This held true whether the effects were measured after short, medium or long-term follow-up periods, suggesting that walking could be a viable and potentially more accessible alternative to other exercise programs.

The benefits of walking extend beyond just pain relief. Studies have shown that incorporating a daily walking routine can have a significant impact on overall health and well-being. Research indicates that taking more than 5,000 steps per day can help prevent or improve chronic pain conditions, while a goal of at least 7,000 steps daily is recommended for cardiovascular health.¹¹ Ideally, however, strive for 10,000 steps a day.

These findings underscore the multifaceted benefits of walking as a form of exercise, addressing not only back pain but also contributing to broader health improvements. Interestingly, the studies found that adding walking to an existing exercise routine did not provide additional short-term benefits beyond those achieved through exercise alone.

This suggests that walking could potentially replace more complex or equipment-dependent exercises in pain management programs, offering a simpler and more cost-effective approach.

The use of pedometers provides motivation and can help you increase daily step counts,¹² which could further enhance the effectiveness of walking-based interventions. As research continues, exploring different walking intensities and durations may provide even more insights into optimizing this accessible form of exercise for chronic low back pain management.

For example, experimenting with backward walking, which tends to shift your body's center of gravity, can reduce the load on your lower back. This altered biomechanics may provide relief for some individuals with chronic low back pain. Backward walking also eliminates the typical heel-strike to the ground, so it can lead to changes in pelvis alignment that may potentially alleviate pressure associated with low back pain.¹³

Walking Is a Simple, Powerful Key to Longevity

A review published in GeroScience highlights the crucial role of regular physical activity, particularly walking, in promoting healthy aging and longevity.¹⁴ The researchers emphasize that walking is not just a basic exercise but a potent antiaging intervention. It has been shown to lower the risk of age-related chronic diseases such as heart disease, high blood pressure, Type 2 diabetes and cancer. Moreover, walking can alleviate pain and enhance function in musculoskeletal conditions.

The benefits of walking extend beyond physical health, however, improving sleep quality and increasing resilience. Perhaps the most remarkable finding is that walking may have the potential to reverse the fundamental cellular and molecular mechanisms associated with aging. The study reveals that regular exercise, including walking, can revitalize mitochondria — the powerhouses of your cells.¹⁵

It stimulates the formation of new mitochondria and enhances the efficiency of existing ones, leading to improved energy production. This is particularly significant because mitochondrial damage due to aging can result in various health issues, including muscle weakness, heart problems and reduced brain blood flow.

While comprehensive research on walking's effects on mitochondrial function is still developing, initial studies show promising results. For instance, a study found that a four-month program of regular low-intensity walking significantly improved mitochondrial health in individuals with impaired glucose tolerance.¹⁶

The walking regimen increased the expression of genes related to mitochondrial creation and function in skeletal muscle. In essence, this research suggests that the simple act of walking can stimulate your body to produce more efficient mitochondria, potentially slowing down or even reversing some aspects of cellular aging.

Meanwhile, walking even 8,000 steps once or twice a week is associated with significantly lower all-cause and cardiovascular mortality risk.¹⁷ So tracking daily steps — and increasing them when necessary — makes sense.

The Goldilocks Zone: Walking Is a Moderate Intensity Exercise That Cannot Be Overdone

While it's well-known that many Americans don't exercise enough, there's a growing recognition that excessive vigorous exercise can actually be detrimental to health. This insight was notably presented in a groundbreaking study by Dr. James O'Keefe and colleagues from the Mid-America Heart Institute at St. Louis Hospital in Kansas City, which challenged conventional wisdom about exercise intensity.¹⁸

The study revealed that for sedentary individuals who start exercising, there's a dose-dependent improvement in various health markers, including reduced mortality, diabetes, depression, high blood pressure, coronary disease, osteoporosis, sarcopenia and fall risk. However, the benefits don't continue to increase indefinitely with exercise intensity.

In fact, those engaging in high volumes of vigorous exercise may begin to lose longevity benefits. For instance, individuals in their 40s and 50s participating in full-distance triathlons face an up to 800% increased risk of atrial fibrillation.

Interestingly, the research highlights that moderate exercise — defined as activity that leaves you slightly breathless but still able to converse — shows a clear "more is better" effect without apparent upper limits.

Moreover, moderate exercise, which includes walking, appears to be about twice as effective as vigorous exercise in improving all-cause survival rates. This finding suggests that when it comes to exercise, the "sweet spot for health benefits" may lie in consistent, moderate activity like walking rather than intense workouts. When seeking the Goldilocks Zone for walking, O’Keefe said:

"Clearly, more is better. You get the big gains going from sedentary lifestyles — 2,000 to 3,000 steps a day — up to 7,000 or 8,000. [Here] you have this very steep reduction in mortality, improvement in survival. It continues to about 12,000 steps a day. Most of the studies show that it plateaus at 12,000."

Five Strategies to Level Up Your Walking Routine

Whether you struggle with back pain or not, walking is a powerful physical activity that you should incorporate into your regular routine. It’s free and you can do it virtually anytime and anywhere, including during your lunch break, early in the morning or, if you’re a parent, while you’re waiting at your child’s sports practice or other activity.

Walking is so important that I recommend you get in your walking first, then add other forms of exercise on top of that. Simply getting out and getting moving can lead to valuable physical and mental health gains, but as your fitness improves or you seek to maximize the benefits of your walking routine, you might want to explore ways to increase the effectiveness of your walks.

By incorporating various strategies, you can enhance your walking routine to target different aspects of fitness while maintaining its moderate intensity and back-friendly nature. To level up your walking routine, consider:

1. Walking with a weighted vest — The extra weight engages more muscles, helping to build strength and endurance.¹⁹ Be aware that if the weight is not evenly distributed or if you compensate by altering your gait, it can lead to imbalances and musculoskeletal issues, such as back pain or shoulder strain.

   To minimize these risks, it’s important to start with a light weight and gradually increase the load as your body adapts, while ensuring proper fit and weight distribution of your vest.

2. Nordic walking — This involves walking with fixed-length ski poles and uses 90% of your muscles, providing a lower and upper body workout in one. It also requires about 18% to 25% more oxygen consumption compared to walking without poles at the same speed.²⁰

3. Walking outdoors — Engaging in outdoor walks, especially in forested areas, can provide substantial psychological advantages beyond those of regular walking. These nature-immersed strolls have been shown to significantly improve mental health by diminishing a range of negative emotional states.

   Participants often report decreased feelings of depression, reduced tension and anxiety, lowered anger levels, and less fatigue and confusion.²¹ Walking outside at solar noon — wearing minimal clothing — will also maximize the benefits of sun exposure.

4. Walking with a friend — Adding a social element to your walks adds to the benefits. According to O’Keefe, "Exercising and making social connections at the same time, that is an absolute goldmine of a longevity activity. That means that even walking with your dog or your friend … is huge … The whole thing is to move your body in a fun, playful manner and make it social."

5. Walking with a purpose — You can harness the time you spend walking for creative purposes, learning or productivity. In addition to listening to audiobooks or podcasts, you can use the time for self-reflection or brainstorming.

   Deborah Grayson Riegel, who teaches leadership communication at Duke University’s Fuqua School of Business, wrote in Harvard Business Review, "Charles Darwin, Friedrich Nietzsche, William Wordsworth, and Aristotle were all obsessive walkers, using the rhythm of walking to help them generate ideas. And while any form of exercise has been shown to activate the brain, walking is a proven creativity booster as well."²²

Remember to introduce any new elements gradually and listen to your body. What works for one person may not be suitable for another, especially when dealing with back pain. However, embracing a regular walking routine that works for your fitness level is a powerful method that not only aids in back pain relief but also contributes to your overall health and fitness.

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