Being active has a range of health benefitsSergio Azenha/Alamy
People who have recurring bouts of lower back pain seem to avoid the discomfort for longer if they go for regular walks.
More than 600 million people worldwide experience pain in this part of the back, which often recurs after initially resolving. Despite this high prevalence, there is very little research into its prevention, says Tash Pocovi at Macquarie University in Sydney, Australia.
Wanting to find an affordable and relatively accessible way for people to avoid the pain returning, Pocovi and her colleagues designed “WalkBack”, the first controlled trial of its kind.

The researchers selected 701 people, aged between 20 and 82 years old, who lived throughout Australia and had experienced an episode of lower back pain without a specific diagnosis, such as a fracture or infection, within the previous six months that then resolved.
On average, they had each had 33 episodes of lower back pain, which interfered with their daily activities and lasted at least 24 hours. None of the participants regularly chose to go for recreational walks or engaged in any kind of exercise programme for pain management.
The scientists asked 351 of them to develop an individualised walking programme with the help of a private physical therapist, aiming for a gradual build-up to 30 minutes of walking, five days a week, within six months. The programme varied according to each individual to help them stick to it, says Pocovi. By 12 weeks, the participants were walking an average of 130 minutes per week.
They were also told about the latest scientific knowledge regarding lower back pain, which was meant to reassure them that it is safe to move under the supervision of their physical therapist, says Pocovi. “A lot of people become avoidant and fearful of movement when they have a history of back pain,” she says.
The remaining 350 volunteers received no such education or walking programme recommendation. Pocovi and her team followed all the participants for up to three years. Regardless of which group they were in, they were free to seek any additional treatment for their pain.

On average, those in the treatment group had their first recurrence of activity-limiting lower back pain 208 days after the study began, compared with 112 days in the control group.
Furthermore, half the people in the control group sought other interventions, such as massages and chiropractic treatment, compared with only 36 per cent of those following the walking and education programme. However, the latter group was more likely to experience mild complications of exercise, such as sprains.
“I think this is probably a handy tool that clinicians and even patients can go to their clinicians with,” says Pocovi.

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