Can a Walking Program Reduce the Recurrence of Low Back Pain?
Physical Therapy for Low Back Pain in Holly Springs, NC
Low back pain is the leading cause of disability and frequently reoccurring. Rates of
hospitalization associated with low back pain have been estimated between
13.4%-18.7% and
around $1,226.25 per patient/annually.1 Although exercise is often recommended for the prevention of low back pain, there was not a consensus on what is the most simple method with few barriers to entry. The WalkBack Randomized Control Trial by Lancet in 2024 looked to establish a low cost, effective, and accessible walking program that could reduce the rate of recurrence of low back pain.
In the WalkBack Study, they found that walking and education by physical therapists decreased the recurrence risk of low back pain by nearly 30% and extended pain-free time by 96 days on average.2 The follow up study in 2025 identified that when patients did have flare-ups, they were shorter in duration (3 vs 4 days) and milder in intensity.3
These positive benefits were achieved with only a structured walking program and accountability— no expensive monthly gym membership or equipment needed. Because walking is accessible, safe, scalable, and effective in reducing the recurrence of low back pain, it should be considered our baseline for physical activity. From there, outcomes could improve even more from the additional benefits of progressive strength training by improving tissue resiliency for functional strength and capacity.
References:
Fatoye F, Gebrye T, Mbada CE, Useh U. Clinical and economic burden of low back pain in low- and middle-income countries: a systematic review. BMJ Open. 2023;13(4):e064119. Published 2023 Apr 25. doi:10.1136/bmjopen-2022-064119
Pocovi NC, Lin CC, French SD, et al. 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. Lancet. 2024;404(10448):134-144. doi:10.1016/S0140-6736(24)00755-4
Pocovi NC, Graham PL, Adelaide A, et al. Effect of a Walking Plus Education Program on the Duration and Severity of Recurrences of Low Back Pain: A Secondary Exploratory Analysis of the WalkBack Trial. J Orthop Sports Phys Ther. 2025;55(9):1-6. doi:10.2519/jospt.2025.13361
