Walking and back pain

When it comes to chronic back pain, does walking actually help?

The benefits of foam rolling 1By Mike Chen, MTI Physical Therapist

Almost every person has experienced low back pain at some point in their lives. Most of the time, that pain is short-lived. But unfortunately for some, the issue either never goes away or comes back again, significantly impacting how people live their lives. When back pain becomes chronic and can’t be attributed to a specific acute injury, one of the most common pieces of advice given is to move around more and try to incorporate more walking into one’s daily routine. But does simply walking actually help chronic low back pain?

A recent study in the Journal of Orthopedic & Sport Physical Therapy compared the results of several other studies to compare the effectiveness of walking, cycling, and swimming to determine if these activities alone can improve chronic low back pain. The study defined chronic low back pain as pain between the bottom rib and your glutes without a specific cause (such as infection, acute injury, disease, recent spinal surgery) and without radiating nerve pain down the legs. Surprisingly, walking, cycling, and swimming alone were found not to be very effective in improving chronic low back pain in the long-term. In the short-term, general activity such as walking was better than doing nothing. However, people who participated in more specific interventions (whether an active intervention, like targeted trunk exercise, or a passive intervention, like manual therapy or massage) had better long-term outcomes.

My clinical experience with chronic low back pain is that it can be attributed to multiple factors. Initially, general movement to tolerance is the recommended treatment, as the study found. However, long-term improvement requires some investigating to see if there is a deficit in the low back or if there is something else affecting your lower back, such as a stiff thoracic spine, stiff hips, or weak glutes. Besides mechanical deficits, our nervous system also can be the culprit with chronic issues. Our body is great at adapting to the environment, but in cases like this, it can be to our detriment. With chronic pain, our nervous system can become overprotective and give us false positives about different inputs, resulting in feeling pain even though the input is not harmful.

The recommendation for increasing general exercise like walking, cycling, or swimming is often given for chronic low back pain due to the ease of access to these activities. Although general exercise can be helpful in addressing low back pain in the short-term, the best thing to do for long-term improvement is to find activities that address your specific deficits.

—Mike Chen is a physical therapist with MTI Physical Therapy at the WAC, located on the 4th Floor of the Clubhouse in the WAC Wellness Center. WAC members may schedule an appointment with Mike by calling 206.839.4780 or emailing wac@mtipt.com. MTI is in-network with most major health insurance companies.

—Posted March 15, 2022

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