A recent large-scale Norwegian study found that daily walking reduces the risk of chronic lower back pain, with the length of walking being a decisive factor. Researchers from the Norwegian University of Science and Technology analyzed data from over 11,000 adults who had no chronic back pain at the start of the study between 2017 and 2019. All participants wore movement sensors on their thigh and lower back for several days, allowing the research team to objectively measure their walking patterns and intensity.
The study, published in the journal JAMA Network Open, was part of the HUNT health survey, which was repeated between 2021 and 2023. During the follow-up period, participants were asked about their experiences with back pain. In the approximately four years after the initial survey, about 15.5 percent, or over 1,600 participants, reported chronic back pain, defined as complaints lasting at least three consecutive months in the previous year.
Findings revealed that the risk of chronic back pain decreased with increasing walking time. The risk was 23 percent lower among people who walked more than 100 minutes daily compared to those who walked less than 78 minutes per day. A 24 percent reduction was observed for those walking over 125 minutes daily. "The more steps the participants took, the less frequently they experienced back pain," noted the researchers. They concluded that for back health, the duration of walking is more important than the walking speed in reducing back pain.
Although brisk walking also showed a positive effect, it was less pronounced than walking for longer durations. In terms of walking intensity, compared to the group with less than 3.00 MET (metabolic equivalent of task), the group with 3.00 to 3.11 MET had a 15 percent lower risk of chronic low back pain. Walking intensity was measured in MET per minute, and walking volume was measured in minutes per day.
The researchers acknowledged limitations in their study. Walking activity was measured only at one point in time and may have changed over the years. It is possible that participants who walked more were already more health-conscious, which could also affect their back health. Unaccounted factors, such as other forms of physical activity or changes in health during the follow-up period, may have influenced the results.
Despite these limitations, the research team believed the results provided important insights for prevention. Walking is considered one of the easiest and most accessible forms of exercise, as it does not require special equipment and can be practiced anywhere. Health promotion programs could specifically focus on encouraging walking, according to the authors.
"Measuring activity with step counters and other wearables is a suitable approach," said Bernd Kladny, the Deputy Secretary General of the German Society for Orthopaedics and Trauma Surgery. He emphasized, "For back health, the amount of movement counts—for heart and circulation, however, the intensity is more important."
The HUNT study is a large-scale health survey with tens of thousands of participants, including 11,194 adults with a mean age of 55.3 years. Of the participants, 58.6 percent were women. All participants were free of chronic low back pain at baseline and had at least one valid day of accelerometer-measured walking data. The participants were investigated for the occurrence of low back pain for an average of 4.2 years.
Physical activity to manage and prevent chronic low back pain has been suggested, but few studies have objectively quantified walking habits in daily life to examine their actual preventive effects. The research indicates that both walking volume and intensity are associated with a lower risk of chronic low back pain. Walking volume showed a stronger protective effect against chronic low back pain than walking intensity, though walking intensity also has a secondary protective effect.
Chronic lower back pain is one of the most common health conditions worldwide, posing a burden on individuals and healthcare systems. Back pain is widespread, with approximately 600 million people worldwide suffering from lower back pain, which is considered a leading cause of disability. According to the Robert Koch Institute, back pain has long been one of the biggest health problems in Germany.
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