A Macquarie University study has found that adults with a history of lower back pain can significantly lengthen the time between pain recurrences by walking regularly. The study included 701 adults who took part in a walking program, which showed a median delay of 208 days before experiencing pain again, compared with 112 days for those who did not take part in the program. The findings, which highlight the cost-effectiveness and accessibility of walking as a preventative measure, could inform future strategies for managing back pain. The team now aims to integrate these findings into routine patient care.
New research shows that regular walking significantly extends pain-free periods in adults with low back pain, proving the effectiveness and affordability of walking as a preventive measure.
A groundbreaking study has found that adults with a history of low back pain went nearly twice as long without a relapse if they walked regularly. Low back pain affects approximately 800 million people worldwide and is a leading cause of disability and reduced quality of life.
Recurrent episodes of low back pain are also common, with seven in 10 people recovering from an episode that will return within a year. Current best practices for the management and prevention of low back pain suggest a combination of exercise and education. However, some forms of exercise are not accessible or affordable for many people due to their high cost, complexity, and need for supervision.
Macquarie University Clinical Trial
A clinical trial from Macquarie University’s Spinal Pain Research Group has investigated whether walking can be an effective, cost-effective and accessible intervention.
The trial followed 701 adults who had recently recovered from an episode of low back pain, with participants randomly assigned to either an individual walking program and six physical therapist-led educational sessions for six months, or to a control group. Researchers followed the participants for one to three years, depending on when they joined, and the results are now published in the latest edition of The Lancet.
Macquarie University spinal pain researchers Professor Mark Hancock and Dr Natasha Pocovi. Credit: Macquarie University
According to the paper’s lead author, Mark Hancock, a professor of physiotherapy at Macquarie University, the findings could have a major impact on the way lower back pain is treated.
“The intervention group had lower rates of activity-limiting pain compared with the control group, and a longer average time before they had a recurrence, with a median of 208 days compared with 112 days,” said Professor Hancock. “Walking is a cheap, widely accessible and simple exercise that almost anyone can do, regardless of geographical location, age or socioeconomic status. We don’t know exactly why walking is so good for preventing back pain, but it’s likely to be the combination of the gentle oscillating movements, the loading and strengthening of spinal structures and muscles, relaxation and stress relief, and the release of ‘feel-good’ endorphins. And of course we know that walking has many other health benefits, including cardiovascular health, bone density, healthy weight and improved mental health.”
Cost-effectiveness and accessibility of walking
According to lead author Dr. Natasha Pocovi, the program was not only much more cost-effective, but also pain-free for much longer.
“Not only did it improve people’s quality of life, it also reduced their need for medical support and the amount of time they spent away from work by about half,” she says. “Previously studied exercise-based interventions for preventing back pain are typically group-based and require close clinical supervision and expensive equipment, so they are much less accessible to most patients. Our research has shown 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.”
To build on these findings, the team now hopes to investigate how they can integrate the preventive approach into routine care for patients experiencing recurrent low back pain.
Reference: “Effectiveness and cost-effectiveness of an individualised, progressive walking and educational intervention for the prevention of recurrence of low back pain in Australia (WalkBack): a randomised controlled trial” by Natasha C Pocovi, Chung-Wei Christine Lin, Simon D French, Petra L Graham, Johanna M van Dongen, Jane Latimer, Dafna Merom, Anne Tiedemann, Christopher G Maher, Ornella Clavisi, Shuk Yin Kate Tong and Mark J Hancock, 19 June 2024, The Lancet.
DOI file: 10.1016/S0140-6736(24)00755-4
The research was funded by the National Health and Medical Research Council.