Prevent low back pain with this simple lifestyle change
Low back pain affects at least 619 million people worldwide, and that number is expected to increase to 843 million people by 2050, according to research estimates.
Unfortunately, nearly 70% of people who recover from an episode of low back pain have a recurrence within a year, experts say. In addition to acute physical discomfort and lost time at work, treatment often requires education, physical therapy and exercises such as
Pilates that may require fees or specialized equipment.
Yet there is an easy, free way to prevent low back pain, at least for a while, according to a new randomized clinical trial.
People in the study who walked regularly after having at least one episode of low back pain were pain free nearly twice as long as those who did not.
“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,” said senior author Mark Hancock, a professor of physiotherapy at Macquarie University in Sydney.
“Walking is a low-cost, widely accessible and simple exercise that almost anyone can engage in, regardless of geographic location, age or socio-economic status,” Hancock said in a statement.
Walking for at least 30 minutes
The study, published Wednesday in The Lancet journal, followed 701 Australian adults, mostly women in their 50s, who had recently recovered from an episode of low back pain that derailed their ability to perform daily activities. Each person was randomly assigned to a control group with no intervention or an individualized walking and educational program.
Those in the intervention group were asked to build up to 30 minutes of walking five times a week over a six-month period at speeds adjusted for age, physical capacity and individual preferences. Jogging was also allowed.
“After three months, most of the people who took part were walking three to five days a week for an average of 130 minutes in total,” Hancock told CNN via email.
Participants were asked to wear pedometers to track their daily steps and keep a walking diary. At three months into the program, they also wore an accelerometer that objectively measured 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 cost-effective model than typical treatment, Hancock said.
“We included 3 standard sessions with a physiotherapist and 3 brief phone catch ups,” he said in an email. “In the few previous studies of prevention exercise programs for back pain the intervention included approximately 20 group classes.
“We also discussed simple strategies to reduce the risk of a recurrence of low back pain and instructions on how to self-manage any minor recurrences. The education was embedded in the same sessions as the walking prescription.”
Cost-effective intervention
In addition to providing participants with longer pain-free periods, the walking program reduced the amount of time taken off work and medical visits by half, said lead study author Natasha Pocovi, a postdoctoral fellow at Macquarie.
“The exercise-based interventions to prevent back pain that have been explored previously are typically group-based and need close clinical supervision and expensive equipment, so they are much less accessible to the majority of patients,” Pocovi said in a statement.
“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.”
Ward off a recurrence of low back pain with a regular walking program of at least 30 minutes for five or more days each week.
Due to the structure of the study, it was not possible to determine how much of the benefit was due to walking or the educational program provided by physiotherapists, Hancock said.
“We believe it is likely 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 appeared to be behavioral coaching, and not actual physical therapy, the act of walking may indeed have been the key 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 important, as 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.”
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