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Low Back Pain? Take a Walk!

A randomised controlled trial of adults with recurrent low back pain (LBP) has shown that a program of progressive walking and education intervention significantly reduced low back pain recurrence.
 
WalkBack trial was a two-armed, randomised controlled trial, of Australia adults who recently recovered from an episode of non-specific low back pain, not attributed to a specific diagnosis. Patients were randomized to either an individualised, progressive walking and education intervention, six sessions over 6 mos., facilitated by a physiotherapist versus a no treatment control group.  Participants were followed for 12-36 months. The primary outcome was days to the first recurrence of an activity-limiting episode of low back pain.
 
A total of 701 patients were randomized (351 intervention group vs 350 control group). Participants were 81% female with a mean age of 54 years. 
 
Those assigned to the walking/education intervention had significantly: 
  • less activity-limiting LBP recurrence (H 0.72;95% CI 0·60–0·85, p=0·0002)
  • longer interval to recurrence (208 days vs 112 days in the control group)
 
The incremental cost per QALY gained was AU$7802, giving a 94% probability that the intervention was cost-effective at a willingness-to-pay threshold of $28 000. 
 
While adverse events were similar in the two gros (52% vs 54%), the intervention group had more adverse events related in the lower extremities than the control group (100 vs. 54 in the control group).
 
Walking is safe, and cost effective intervention for low back pain management.

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Disclosures
The author has no conflicts of interest to disclose related to this subject
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