Doctor, my back pain has improved: Can walking prevent it from coming back again?

In this study, the WalkBack program, which includes personalized walking guidance and learning about back care, helped keep back pain away longer than not following the WalkBack program.

What is the evidence?

WalkBack compared to no treatment

Outcome	WalkBack	No treatment	Effect
Number of days until back pain* returned	208 days	112 days	People who followed the WalkBack program had 96 more days free of back pain* than people who did not use the program
Total walking (minutes per week) at 3 months	164	113	People who followed the WalkBack program walked an average of 51 minutes longer per week than people who did not use the program
Total walking (minutes per week) at 12 months	160	159	Both groups were doing the same amount of walking

*severe enough to interfere at least somewhat with daily activities for at least 24 hours

What kind of study was this?

This was a randomized controlled trial.

Who? The study included 701 adults who had recovered from a recent episode of low back pain that did not have a clear cause. Participants were mostly women, with an average age of 54 years and most people reported more than 30 episodes of the same back pain in the past. People who had other medical conditions that prevented them from walking or were already walking 3 or more times a week or had spinal surgery within the past 6 months were excluded.

What? The study compared people who were randomly assigned to the WalkBack program with people who did not receive any specific treatment.

Treatment	vs	Placebo/Usual care/another treatment
WalkBack Program: Six sessions with a physiotherapist focusing on developing a program of gradually increased time walking for each person based on their current level of walking, age, and body-mass index (BMI). The goal was to walk 5 times per week for at least 30 minutes daily by 6 months. Educational sessions about back health were also provided to explain pain science and reduce fear about moving.		No treatment group: People did their usual activities without any guidance from study physiotherapists or education about pain science.

Treatment

Placebo/Usual care/another treatment

WalkBack Program: Six sessions with a physiotherapist focusing on developing a program of gradually increased time walking for each person based on their current level of walking, age, and body-mass index (BMI). The goal was to walk 5 times per week for at least 30 minutes daily by 6 months.

Educational sessions about back health were also provided to explain pain science and reduce fear about moving.

No treatment group: People did their usual activities without any guidance from study physiotherapists or education about pain science.

Why was this research done?

The WalkBack study tested whether a simple walking program could help keep recurring back pain away longer compared to not following the WalkBack program. The researchers found that the WalkBack program kept back pain away about 3 months longer. By 12 months, both groups were walking about the same amount of time per week on average.

Participants knew which treatment group they were assigned to which means people in the control group may have decided to walk because they wanted to please the researchers. This study also took place during the COVID-19 pandemic so people may have been walking outside more in general. While generally safe, the walking program led to more minor leg issues, not fully explained in the study. These results suggest walking programs could be a good short-term option for managing back pain, but further well-designed studies are needed.

This Evidence Summary is based on the following article:

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 Jun 19:S0140-6736(24)00755-4. doi: 10.1016/S0140-6736(24)00755-4. PubMed

Published: Thursday, August 15, 2024

Please note that the information contained herein is not to be interpreted as an alternative to medical advice from a professional healthcare provider. If you have any questions about any medical matter, you should consult your professional healthcare providers, and should never delay seeking medical advice, disregard medical advice or discontinue medication based on information provided here.

This Evidence Summary was printed from the PAIN+ CPN website on 2024/11/21.

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