How Walking Improves Back Health

Walking is relatively easy and one of the most overlooked ways to help relieve back pain and prevent – or lessen – future flare-ups of low back pain.¹Meng XG, Yue SW. Efficacy of aerobic exercise for treatment of chronic low back pain: a meta-analysis. Am J Phys Med Rehabil. 2015;94(5):358-365. http://doi.org/10.1097/PHM.0000000000000188

Walking Strengthens the Muscles that Support the Spine

Walking strengthens the muscles supporting the spine by actively engaging and contracting the core, back, and leg muscles, which work together to stabilize the spine. Weak muscles from a sedentary lifestyle may cause spine misalignment, leading to fatigue, degeneration, and pain over time.²Valdivieso P, Franchi MV, Gerber C, Flück M. Does a Better Perfusion of Deconditioned Muscle Tissue Release Chronic Low Back Pain?. Front Med (Lausanne). 2018;5:77. http://doi.org/10.3389/fmed.2018.00077^,3Verbunt JA, Smeets RJ, Wittink HM. Cause or effect? Deconditioning and chronic low back pain. Pain. 2010;149(3):428-430. http://doi.org/10.1016/j.pain.2010.01.020

Walking improves muscle strength and endurance through a combination of:

• Improved muscle strength. Walking strengthens the muscles providing better support to the spine, reducing the risk of strain and injury.⁴Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463-470. http://doi.org/10.12965/jer.1632650.325 Walking also strengthens the legs providing extra support and reducing stress on the spine.⁴Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463-470. http://doi.org/10.12965/jer.1632650.325
• Improved muscle endurance. Walking increases the endurance of the core, back, leg, and spinal muscles, making them more fatigue-resistant.⁴Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463-470. http://doi.org/10.12965/jer.1632650.325^,5Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022
• Increased blood circulation. Walking stimulates blood circulation throughout the body, including the muscles. Improved circulation helps deliver fresh oxygen and nutrients, promotes cell growth and repair, and removes metabolic waste products, including toxins, from the muscle tissues.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022
• Increased muscle fiber activation. Walking stimulates different muscle fibers, such as slow-twitch and fast-twitch fibers, promoting their development and enhancing muscle strength.⁶Harber MP, Konopka AR, Douglass MD, et al. Aerobic exercise training improves whole muscle and single myofiber size and function in older women. Am J Physiol Regul Integr Comp Physiol. 2009;297(5):R1452-R1459. http://doi.org/10.1152/ajpregu.00354.2009

Regular walking and strengthening of the core, back, and leg muscles and small stabilizing muscles help support the spine and improve overall posture.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022 Over time, strengthening these muscles through walking supports overall back stability and reduces the risk of injuries and falls.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022

Watch How to Start Walking Program When You Have Low Back Pain Video

Walking Increases Lower Back Flexibility

Walking increases lower back flexibility by engaging the muscles surrounding the lower back and promoting a healthy range of motion. Flexible lower back muscles contribute to reduced pain and improved function in performing daily activities.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022

Walking benefits related to flexibility and range of motion include:

• Reduced muscle tension. Walking engages and stretches the muscles and ligaments surrounding the lower back, such as the hip flexors, gluteal muscles, and hamstrings. Stretching these muscles relieves muscle tension and stiffness, reducing lower back pain.⁷Hodges PW, Smeets RJ. Interaction Between Pain, Movement, and Physical Activity: Short-term Benefits, Long-term Consequences, and Targets for Treatment. Clin J Pain. 2015;31(2):97-107. http://doi.org/10.1097/AJP.0000000000000098
• Increased spinal movement. Walking involves a wide range of motions, including flexion, extension, rotation, and lateral bending, that help improve the flexibility of the lower back, reducing stiffness and the risk of disc degeneration.⁷Hodges PW, Smeets RJ. Interaction Between Pain, Movement, and Physical Activity: Short-term Benefits, Long-term Consequences, and Targets for Treatment. Clin J Pain. 2015;31(2):97-107. http://doi.org/10.1097/AJP.0000000000000098
• Increased joint mobilization. Walking involves regular weight-bearing and repetitive motion, which helps mobilize and lubricate the joints, including those in the lower back.⁸Vincent HK, Vincent KR, Seay AN, Conrad BP, Hurley RW, George SZ. Back Strength Predicts Walking Improvement in Obese, Older Adults With Chronic Low Back Pain. PM&R. 2014;6(5):418-426. http://doi.org/10.1016/j.pmrj.2013.11.002 Mobilized and well-lubricated joints are less prone to stiffness, reducing the risk of injuries.⁸Vincent HK, Vincent KR, Seay AN, Conrad BP, Hurley RW, George SZ. Back Strength Predicts Walking Improvement in Obese, Older Adults With Chronic Low Back Pain. PM&R. 2014;6(5):418-426. http://doi.org/10.1016/j.pmrj.2013.11.002

Having flexible muscles and ligaments around the spine serves to improve posture, reduce strain on the discs, and promotes natural spine curvature.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022

Additional Ways Walking Helps Heal Back Pain

Committing to a regular walking program may provide additional benefits, including:

• Increased bone density. Walking requires that the bones bear the weight of the upper body, and this weight-bearing exercise helps increase bone density, reducing the risk of an osteoporotic fracture.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022
• Enhanced spinal disc health. Walking helps nourish the spinal discs by increasing fluid exchange. The pumping action of walking facilitates the absorption of nutrients and the removal of waste products from the spinal discs, promoting better spinal health and resilience.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022
• Reduced lower back strain. Promoting calorie burn, improving metabolism, and gradually decreasing weight helps minimize the load on the back, ensuring better spinal health and overall well-being.¹Meng XG, Yue SW. Efficacy of aerobic exercise for treatment of chronic low back pain: a meta-analysis. Am J Phys Med Rehabil. 2015;94(5):358-365. http://doi.org/10.1097/PHM.0000000000000188
• Increased production of natural painkillers. Walking – especially at a moderately intense pace – stimulates the release of endorphins, the body’s natural feel-good hormones that reduce pain and stress.⁴Lee JS, Kang SJ. The effects of strength exercise and walking on lumbar function, pain level, and body composition in chronic back pain patients. J Exerc Rehabil. 2016;12(5):463-470. http://doi.org/10.12965/jer.1632650.325^,9Robertson R, Robertson A, Jepson R, et al. Walking for depression or depressive symptoms: a systematic review and meta-analysis. Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. 2012. Available from: https://www.ncbi.nlm.nih.gov/books/NBK99429/

Walking may be a natural and enjoyable way to alleviate low back pain. By gradually improving cardiovascular fitness, patients will find that they are able to engage in additional physical activities to further strengthen and support their back.

Precautions for Walking with Back Conditions

There are a few conditions that warrant caution before starting a new walking exercise routine, including:

• Acute back injury. A recent back injury, such as a muscle strain, sprain, vertebral fracture, or other injury, may require a short rest and healing before engaging in any exercise, including walking.
• Herniated disc. A lumbar herniated disc occurs when the nucleus pulposus (soft core) of a spinal disc pushes out into the layers of the annulus fibrosus (outer covering) at varying degrees, potentially causing nerve compression and pain. Walking may aggravate symptoms in some cases.¹⁰Dydyk AM, Ngnitewe Massa R, Mesfin FB. Disc Herniation. [Updated 2023 Jan 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441822/
• Spinal stenosis. Spinal stenosis refers to narrowing of the spinal canal, which may lead to nerve compression and pain. Walking on level surfaces may be well-tolerated, but individuals with spinal stenosis may experience discomfort or pain when walking downhill or for extended periods.¹¹Oğuz H, Levendoğlu F, Oğün TC, Tantuğ A. Loading is more effective than posture in lumbar spinal stenosis: a study with a treadmill equipment. Eur Spine J. 2007;16(7):913-918 http://doi.org/10.1007/s00586-007-0317-y^,12Tomkins-Lane CC, Holz SC, Yamakawa KS, et al. Predictors of Walking Performance and Walking Capacity in People With Lumbar Spinal Stenosis, Low Back Pain, and Asymptomatic Controls. Physical Medicine and Rehabilitation. 2012;93(4):P647-653. https://doi.org/10.1016/j.apmr.2011.09.023

It is advisable to consult with a physician or physical therapist to discuss any concerns and provide prescribed guidance and exercises.

Water Therapy as a Gentle Alternative to Walking

For some with lower back pain, even a generally well-tolerated exercise such as walking is too painful. In these cases, walking and other exercises may be performed in a pool – called aquatic therapy – so that the water provides buoyancy and reduces the impact on the lower back.¹³Baena-Beato PÁ, Artero EG, Arroyo-Morales M, Robles-Fuentes A, Gatto-Cardia MC, Delgado-Fernández M. Aquatic therapy improves pain, disability, quality of life, body composition and fitness in sedentary adults with chronic low back pain. A controlled clinical trial. Clinical Rehabilitation. 2014;28(4):350-360. http://doi.org/10.1177/0269215513504943

Tips for Starting a Walking Routine

The following considerations may be helpful for starting a walking routine:

• Set realistic goals. Start with achievable goals based on both fitness level and back pain intensity. Begin with a 5 to 10-minute walk every day and gradually increase the duration.
• Be consistent. Make walking a regular part of a routine by walking at the same time every day.
• Make it social. Invite friends or join a walking group for motivation and accountability.
• Use fitness apps. Track progress and get feedback with fitness apps and wearable devices.
• Bring headphones. Make walking enjoyable by listening to audiobooks, podcasts, or a favorite playlist.

Starting a regular walking program immediately, being consistent, and making it enjoyable may have both immediate and long-term benefits in improving lower back health, restoring function, and preventing pain.⁵Gordon R, Bloxham S. A Systematic Review of the Effects of Exercise and Physical Activity on Non-Specific Chronic Low Back Pain. Healthcare (Basel). 2016;4(2):22. http://doi.org/10.3390/healthcare4020022