A new study out of Australia demonstrates, once again, the benefits of walking and its positive impact on physical health. The study looked at walking as a treatment for low back pain, which is estimated to affect 800 million people worldwide. There’s a good chance you know someone or are personally affected by it, too. It is by far one of the leading causes of disability and reduced quality of life, and as someone who has suffered from back pain myself, I couldn’t agree more.
The Study
Entitled “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,” was a simple yet effective design. A total of 701 people aged 18 had been diagnosed with non-specific low back pain not attributed to a specific diagnosis that had affected them for at least 24 hours. They found a bunch of people who had back pain but didn’t know why or how the pain came about. This is the most common way back pain presents for most people; it seemingly shows up out of nowhere to ruin your day.
These 701 people were then split into two groups. The treatment group received six health coaching sessions by a physiotherapist designed to help the subjects start and, more importantly, continue their walking regimen. The health coaching sessions also provided information about modern pain science and to reduce the fear of having low back pain, as well as practices to reduce a recurrence of pain in the future. The goal was for participants to walk at minimum for 30 minutes per day, five days a week. The control group received no coaching or walking program and lived usually for a 6-month duration. Although the intervention lasted only six months, researchers continued to collect data on both groups' walking habits and pain for a period of 1 to 3 years.
Since pain is the primary outcome of this study, let’s describe how pain was defined. A recurrence of pain was defined as pain lasting longer than 24 hours, with an intensity greater than two on a 0-10 scale. Another criterion was pain that caused at least somewhat or more significant interference with day-to-day activities based on an adapted version of PI9 of the PROMIS item bank (“How much did low back pain interfere with your day-to-day activities?” Not at all; A little bit; Somewhat; Quite a bit; Very much.)
The Takeaways
You won’t be surprised to learn that walking and health coaching vastly outperformed the control group and were proven to reduce low back pain. This quote from Professor Hancock, one of the study authors, sums it up best:
"The intervention group had fewer occurrences of activity limiting pain compared to the control group, and a longer average period before they had a recurrence, with a median of 208 days compared to 112 days."
The intervention group had nearly 100 more pain-free days than the control group. Less pain wasn’t the only good news. The intervention group also required fewer visits to a healthcare professional to treat their pain and took less time off work by about 50%.
In my opinion, the best part of this study is how a straightforward exercise can have such a profound effect for such a low cost. Many more people have access to a pair of shoes and a safe place to walk than have access to physical therapy, a gym membership, or visits with a doctor.
Dr. Natasha Pocovi, the lead author, has this to say:
"Our study has shown that this effective and accessible means of exercise has the potential to be successfully implemented at a much larger scale than other forms of exercise."
Why Walking Works
The authors cited no specific reason for the effectiveness of walking but rather a combination of events. First of all is ‘motion is lotion’ theory. Gentle oscillatory movements, combined with the loading and strengthening of spinal structures and muscles that are produced by walking, are most likely the physical adaptations that help to reduce pain.
Also, the known mental health effects, such as mood enhancement and stress relief that come with exercise, aid the effort. The mental and emotional toll that pain takes cannot be understated. For all the advancements in modern medicine, pain is still an area that isn’t completely understood. What is known, though, is that chronic low back pain can have an enormous impact on a person’s mental health, and it can be quite a devastating cycle. People who suffer from low back pain are more likely to suffer from depression, and people with depression are more likely than the general population to have low back pain.
My takeaway from all this? Grab a friend and go for a nice long walk. You’ll get exercise, some positive social interaction, and take care of your physical and mental health all at once.
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As you say, walking can’t be underestimated. Getting in 4000 to 8000 steps a day is the cheapest and easiest way to live longer, healthier, happier lives. And almost everyone has access to it!
If you must, you can pay for it too. Every gym has a Dreadmill or two.