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Low back pain affects at least 619 million people worldwide, and that number is expected to rise to 843 million people by 2050, according to research estimates.
Unfortunately, nearly 70% of people who recover from an episode of low back pain experience a recurrence within a year, according to experts. In addition to acute physical discomfort and time lost from work, treatment often requires education, physical therapy, and exercises like Pilates that may require fees or specialized equipment.
Yet, according to a new randomized clinical trial, there is a simple and free way to prevent lower back pain, at least for a while.
People in the study who walked regularly after having at least one episode of low back pain were pain-free for almost twice as long as those who didn’t.
“The intervention group had less activity-limiting pain than the control group and a longer average time before a recurrence, with a median of 208 days compared to 112 days,” said lead author Mark Hancock, professor of physiotherapy at Macquarie University, Sydney.
“Walking is an inexpensive, widely accessible and simple exercise that almost anyone can engage in, regardless of geographic location, age or socioeconomic status,” Hancock said in a statement.
The study, published Wednesday in the journal The Lancet, followed 701 Australian adults, mostly women in their 50s, who had recently recovered from an episode of lower back pain that derailed their ability to carry out daily activities. . Each person was randomly assigned to a control group with no intervention or individualized walking and education program.
Members of the intervention group were asked to walk up to 30 minutes five times a week over a six-month period, at speeds adjusted according to age, physical ability and individual preferences. Jogging was also permitted.
“After three months, most participants were walking three to five days a week for an average of 130 minutes total,” Hancock told CNN via email.
Participants were asked to wear pedometers to track their daily steps and keep a walking diary. After three months of the program, they also wore an accelerometer that objectively measured the number of daily steps and the amount of brisk walking or other physical activities.
The program also offered six training sessions guided by a physical therapist over a six-month period, a more cost-effective model than traditional treatment, Hancock said.
“We included 3 standard sessions with a physical therapist and 3 brief telephone catch-ups,” he said in an email. “In the few previous studies of back pain prevention exercise programs, the intervention included approximately 20 group classes.
“We also discussed simple strategies to reduce the risk of low back pain recurrence and instructions on how to self-manage any minor recurrences. Education was integrated into the same sessions as the walking prescription.
In addition to providing participants with longer pain-free periods, the walking program cut time off work and medical visits in half, said the study’s lead author, Natasha Pocovi, a postdoctoral fellow. at Macquarie.
“Exercise-based interventions to prevent back pain that have been explored previously are typically group-based and require close clinical supervision and expensive equipment, so they are much less accessible to the majority of patients,” a Pocovi said in a statement.
“Our study showed that this effective and accessible means of exercise has the potential to be successfully implemented on a much larger scale than other forms of exercise. »
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Avoid recurrence of lower 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 benefits were due to the walking or the educational program provided by the physical therapists, Hancock said.
“We think it is likely that the two components complement each other, with the education helping to overcome avoidance and fear of movement, while the health coaching and walking program leads to behavior change,” he said. -he declares.
However, because the intervention appeared to be behavioral coaching and not actual physical therapy, walking may actually have been the main reason for the improvement, said A. Lynn Millar, a retired physical therapist and former professor at the Winston-Salem State University. in Winston-Salem, North Carolina. She did not participate in the study.
“This is important because many studies have shown that the pain response is in part a behavioral response,” Millar said in an email. “The coaching was of limited duration, so they may suggest that the primary intervention of walking was the main contributor to the long-term response.”
What walking does for the body
What is so helpful about walking for lower back pain relief? On the one hand, exercise is good for all parts of the body.
“First, the person is sitting less and sitting is not the best posture for the back,” Millar said. “Secondly, walking will improve overall circulation and improve blood flow to the back muscles that actively support the individual during movement. Movement of a joint also helps circulate joint fluids, allowing the joints in the spine to benefit from the movement.
Walking improves metabolism and the amount of calories burned, experts say. Lower weight can lessen the load on the back and legs, ensuring better spinal health. Taking a brisk walk also improves the strength of the core muscles around the spine and legs, which can improve posture and provide better support for the spine.
Walking also increases muscular endurance, ensuring that muscles are less susceptible to fatigue and injury. Weight-bearing exercises such as walking increase bone density, protecting against injury while stimulating the release of endorphins, the body’s natural feel-good hormones that reduce pain and stress.
When beginning a walking program, good shoes and arch supports are necessary, and potential problems can be offset with exercise programs such as resistance training and stretching, Millar said.
“I also think it’s important to have varied paces and distances throughout the week. Some problems are caused by progressing too quickly and not paying attention to the initial pain,” she said.
“I also used to see people walking in shoes that didn’t have good support, or that were so worn out that the support was gone,” she added.
If your “back collapses” while walking, a modification of your activities, such as cycling or swimming, may be necessary, Millar said. Taking a day or two off to walk and do back exercises and stretches can also help.
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