- Lower back pain is the most common cause of disability worldwide, and avoiding exercise can actually make it worse, according to some research.
- A study found benefits to a 12-week run/walk program, including decreased pain intensity and disability.
- Experts explain how to keep moving, despite back pain.
Nearly 620 million people worldwide have chronic low back pain, according to the World Health Organization, and prevalence in the U.S. is high. One estimate notes that up to 28 percent of Americans may struggle with the issue at some point in their lives, and 44 percent of those with chronic back pain report having it for five years or longer.
Potentially making back pain worse: Avoidance of exercise. Some people believe that physical activity—especially any kind of intense or high-impact exercise like running—will lead to a higher pain level and mobility limitations. However, research suggests the opposite may be true.
Published in the British Journal of Sports Medicine, a recent study recruited 40 men and women aged 18 to 45 with chronic low back pain to assess whether running was beneficial or detrimental for their pain intensity.
Half the participants undertook a 12-week, run/walk training program comprised of three 30-minute sessions per week delivered by an exercise physiologist. Throughout the program, they reported on pain intensity and disability. A control group continued with their usual back pain care without any running exercises.
At the end of the three months, those in the run/walk group showed significant improvements in pain and disability compared to the control group. For example, pain intensity decreased by more than 19 points on a 100-point scale, and disability dropped by 5 points.
“The takeaway from the study is that, for most people with low back pain, running is safe if you start small and build up gradually,“ said lead author Chris Neason, Ph.D.(c), a researcher and exercise physiologist at Monash University in Australia. He told Runner’s World that running helps load spinal discs in a way that other exercise, like cycling or swimming, doesn’t.
“Our spinal discs respond well to this loading, and it can strengthen the back muscles and may have an anti-inflammatory effect,” he said. “We also saw in our study that running improved confidence and led to better mental health.”
There are other mechanisms that are also helpful, according to Tracy Zaslow, M.D., primary care sports medicine specialist at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles and a team physician for Angel City Football Club and LA Galaxy.
She told Runner’s World that exercise improves circulation throughout the body, including the lower back, which facilitates healing. Also, activity boosts strength and flexibility, supporting the muscles along the spine in a way that helps with pain-free movement.
“Exercise also increases release of endorphins, which work as natural pain modulators, and that decreases the sensation of pain,” she said. Adopting a run/walk program is a stellar way to start seeing these benefits, she added.
“Trying to go out and run 30 minutes when you haven’t run at all is going to be tough, as you likely won’t have the strength in the core and leg muscles you need to support the lower back,” said Zaslow. “A run/walk program allows a new runner to gradually improve muscle strength and endurance, and the intervals can be increased over time to build up to longer endurance runs.”
One important caveat, she added: If your lower back pain increases during or after exercise, that’s an indication that your activity could be making chronic pain worse. If that happens, she recommends talking with your doctor and possibly getting a referral to a physical therapist to develop a tailored run/walk program that fits your needs.
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Elizabeth Millard is a freelance writer focusing on health, wellness, fitness, and food.
