About four million Australians and 800 million people globally suffer from low back pain, a significant cause of disability and lower quality of life. Recurrences are common, with 70% of people experiencing another episode within a year.
Professor Mark Hancock and his team from Macquarie University are researching ways to focus on preventing back pain instead of just treating it. This approach helps individuals manage their health and reduces costs for society and the healthcare system.
Unlike the old advice of bed rest for back pain, current best practice recommends exercise and education to treat and prevent back pain. However, many exercises are costly and require supervision, making them inaccessible for some people.
The WalkBack trial tested if walking and education could prevent back pain recurrences. The trial involved 701 adults who had recently recovered from back pain. They were split into two groups: one received a personalized walking program and six education sessions over six months, while the other received no intervention.
Participants were tracked for one to three years to see if they experienced new back pain. The main goal was to compare how many days it took for back pain to return in each group and how it affected daily activities or required medical care. They also examined the cost-effectiveness, including work absences and healthcare costs. The results are now published in the medical journal The Lancet.
The senior author, Professor Hancock, says their findings could significantly impact back pain management. The intervention group had fewer instances of activity-limiting pain and took longer to experience a recurrence (208 days vs. 112 days). The risk of needing medical care for back pain was nearly halved in the intervention group.
Walking is a low-cost, accessible exercise suitable for everyone. While the exact reasons are unclear, walking likely helps by gently moving and strengthening the spine, relieving relaxation and stress, and releasing endorphins.
The senior author, Professor Hancock says their findings could significantly impact back pain management. The intervention group had fewer instances of activity-limiting pain and took longer to experience a recurrence (208 days vs. 112 days). The risk of needing medical care for back pain was nearly halved in the intervention group.
Walking is a low-cost, accessible exercise suitable for everyone. While the exact reasons are unclear, walking likely helps by gently moving and strengthening the spine, relieving relaxation and stress, and releasing endorphins.
Walking has many health benefits, including better heart health, stronger bones, healthy weight, and improved mental health. Professor Hancock explained that the walking program was tailored to each person based on age and physical ability.
Participants aimed to walk 30 minutes five times a week over six months. After three months, most walked three to five days a week for an average of 130 minutes. Professor Hancock noted that you don’t need to walk long distances daily to gain these benefits.
Dr. Natasha Pocovi, the lead author, said, ” The program extended pain-free periods and was cost-effective. It improved quality of life, reduced healthcare visits, and cut time off work by about half.”
Unlike other exercise programs that require supervision and expensive equipment, this walking program is accessible to more people. The team hopes to integrate this preventive approach into routine care for those with recurrent low back pain.
Case study: Rory’s path to reducing back pain
Rory Fagan joined the WalkBack trial in early 2021 to find relief from a rugby-related back injury.
Steps to Success: Former rugby player Rory Fagan says his back pain improved after joining the WalkBack study. He used to have severe flare-ups once or twice a year, but since walking three to four times a week for three years, he has had only one severe episode. His back pain now is less intense and lasts shorter—usually less than a day.
Rory learned that staying active is better for back pain than resting. Exercise helps reduce long-term pain, so he stays active even during flare-ups.
Already an active surf lifesaver, Rory started a walking group for older adults at his club, which has been enjoyable and motivating for everyone involved. “Exercise is just more fun in a group,” he says.
The WalkBack study showed positive results from personalized walking programs developed with physiotherapists. If you want to manage recurring back pain with walking, here are some tips:
- Build up gradually: Start with short walks (10 minutes a few times a week) and slowly increase the time and frequency to avoid injuries.
- Don’t fear mild pain: Mild pain is expected when beginning new activities. Walking will strengthen your back and muscles over time.
- Be accountable: Work with a physiotherapist or find a walking buddy to stay motivated.
- Track your progress: Set goals like increasing steps or stamina. Use a smartwatch, free exercise apps, or a notebook to monitor your progress.
- Stay active during recurrences: If back pain returns, continue walking at a reduced level rather than stopping altogether.
Journal reference:
- Natasha C Pocovi, Prof Chung-Wei Christine Lin et al., Effectiveness and cost-effectiveness of an individualised, progressive walking and education intervention for the prevention of low back pain recurrence in Australia (WalkBack): a randomised controlled trial. The Lancet. DOI: 10.1016/S0140-6736(24)00755-4.