Alleviate chronic lower back ache via this straightforward lifestyle adjustment
Back pain affecting millions globally, and it's increasing - According to global research, over 619 million people are currently afflicted by back pain, a number estimated to rise to 843 million by 2050.
Unfortunately, around 70% of individuals who recover from a bout of back pain experience a recurrence within a year, as indicated by experts. Besides the acute physical discomfort and lost working hours, treatment often involves education, physical therapy, and exercises such as Pilates which may require fees or specific equipment.
However, a simple, cost-effective method to avoid back pain, at least temporarily, has been suggested by a recent randomized clinical trial.
Individuals in the study who regularly walked after experiencing back pain were pain-free for nearly twice as long as those who didn't.
"The intervention group had fewer instances of activity-limiting pain compared to the control group, and a longer average time before a recurrence, with a median of 208 days compared to 112 days," said lead author Mark Hancock, a physiotherapy professor at Macquarie University in Sydney.
"Walking is a low-cost, easily accessible, and simple exercise that almost anyone can participate in, regardless of geographical location, age, or socio-economic status," Hancock said in a statement.
Walking for 30 minutes daily
Published in The Lancet journal on Wednesday, the study followed 701 Australian adults, mainly women in their 50s, who had recently recovered from an episode of back pain that hindered their ability to carry out daily activities. Each individual was randomly assigned to a control group with no intervention or an individualized walking and educational program.
Participants in the intervention group were asked to gradually increase their walking to 30 minutes, five times a week over a six-month period, at speeds adjusted for age, physical capacity, and individual preferences. Running was also allowed.
"By the three-month mark, most of the participants were walking three to five days a week for a total of 130 minutes," Hancock told CNN via email.
Participants were asked to wear pedometers to track their daily steps and keep a walking log. At the three-month mark, they also wore an accelerometer to objectively measure their daily step count and the amount of brisk walking or other physical activity.
The program also provided six physiotherapist-guided education sessions over six months, a more economical approach than typical treatment, Hancock said.
"We included 3 standard sessions with a physiotherapist and 3 brief phone check-ins," he said in an email. "In the few previous studies of prevention exercise programs for back pain, the intervention included approximately 20 group classes."
Cost-effective approach
Apart from providing participants with longer pain-free periods, the walking program cut the number of workdays missed and medical visits in half, said lead study author Natasha Pocovi, a postdoctoral fellow at Macquarie.
"The exercise-based interventions to prevent back pain that have been explored earlier are typically group-based and require close clinical supervision and expensive equipment, so they are less accessible to most patients," Pocovi said in a statement.
"Our study has shown that this effective and accessible form of exercise has the potential to be implemented on a much larger scale than other forms of exercise."
Due to the study's structure, it was not possible to determine whether the benefit was due to walking or the educational program provided by physiotherapists, 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 coaching and walking program resulted in behavior change," he said.
However, because the intervention seemed to be behavioral coaching, and not actual physical therapy, the act of walking may indeed have been the primary reason for improvement, said A. Lynn Millar, a retired physical therapist and former professor at Winston-Salem State University in Winston-Salem, North Carolina. She was not involved in the study.
"This is significant because many studies have shown that pain response is partially a behavioral response," Millar said in an email. "The coaching was limited in duration, thus they can suggest that the primary intervention of walking was the major contributor to the long-term response."
What walking accomplishes for the body
So, what exactly is it about walking that helps with back pain? For starters, exercise benefits the entire body.
"First, the person is sitting less, and sitting is not the best posture for the back," Millar said. "Second, walking will improve overall circulation, and will improve blood circulation to the muscles of the back that are actively supporting the individual during motion. Movement of a joint also helps circulate the joint fluids, thus the joints of the spine may be benefiting from the motion."
Walking increases metabolism and the number of calories burned, experts say. Lower weight can alleviate the load on the back and legs, ensuring better spinal health. A brisk walk also enhances the strength of core muscles around the spine and in the legs, all of which can improve posture and provide better support to the spine.
Walking also increases muscle endurance, ensuring muscles are less prone to fatigue and injury. Weight-bearing exercises such as 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, proper shoes and arch supports are necessary, and potential problems may be offset by exercise programs such as resistance training and stretching, Millar said.
"It's essential to mix up the speeds and distances you cover in a week, as rushing things too quickly and ignoring early discomfort can lead to issues. I've noticed this with many people, some wear shoes with poor support or ones that have worn out, leaving no support at all."
"She continued, 'When your back acts up during a walk, alternatives like cycling or swimming could be beneficial. If needed, taking a day or two break from walking, and focusing on back exercises and stretching can provide relief.'"
-Millar explained.
