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Walking for Back Pain

By Mr Ahmed-Ramadan Sadek, Neurosurgeon · Last reviewed October 2026 · 7 min read

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Key points

  • In the WalkBack trial, a gradual walking programme with education almost doubled the time people stayed free of a new back pain episode.
  • Participants built up to walking about 30 minutes, five times a week, over six months with support from a physiotherapist.
  • Walking helps chronic back pain a little on its own. Other forms of exercise may help a bit more, so walking works best as part of an active routine.
  • People who walk more during the day appear less likely to develop chronic back pain.
  • There is nothing magic about 10,000 steps. Start where you are and build up slowly.

Why walking?

Walking is free, needs no equipment and fits around work and family life. It also matters because back pain tends to come back. Many people recover from one episode only to have another within months. Exercise is known to help prevent recurrences, but until recently nobody had tested whether something as simple as walking would do the job.

The WalkBack trial

WalkBack was a randomised trial from Australia, published in The Lancet in 2024.[1] It recruited 701 adults who had recently recovered from an episode of non-specific low back pain. Half were offered an individualised, progressive walking programme with education, delivered in six sessions with a physiotherapist over six months. The other half received no treatment.

The aim, set out in the trial protocol, was to reach walking at least five times a week for at least 30 minutes by the end of the programme. Each person’s plan was agreed with their physiotherapist, and participants were given a pedometer and a walking diary to help them keep going.[2]

What it found

  • People in the walking group went a median of 208 days before a recurrence that limited their activity, compared with 112 days in the control group.
  • The risk of a recurrence over the follow-up period was reduced by about 28% (hazard ratio 0.72).
  • The programme was judged likely to be cost-effective in the Australian health system.
  • Overall side effects were similar in both groups, but there were more problems affecting the legs and feet in the walking group (100 events compared with 54).[1]

A later analysis of the same trial found that when back pain did return, episodes were slightly shorter and the worst pain slightly lower in the walking group. The authors describe these extra benefits as small and of uncertain clinical importance.[3]

Points to keep in mind

The trial had limitations. Neither participants nor physiotherapists could be blinded, about four in five participants were women, the average age was 54, and the comparison was with no treatment at all rather than with another exercise programme.[1] People who were already walking regularly were excluded.[2] Even so, it is a large, well-run trial and the result is encouraging for anyone who wants a practical way to keep their back healthy.

Can walking help back pain you already have?

For chronic or recurrent low back pain, a review of 19 trials found that walking or running gave a small improvement in pain and disability compared with little or no treatment. It was, however, less effective than the alternative treatments it was compared against.[4] A more recent review of 13 trials of walking programmes found that walking reduced pain (low certainty evidence) and disability (moderate certainty evidence). The biggest benefits were seen at roughly 900 to 1,000 minutes of walking spread over about 8 weeks, which works out at around two hours a week.[6]

Walking also seems to matter for people who do not yet have long-term pain. A Norwegian study fitted more than 11,000 adults with activity sensors and followed them for about four years. Those who walked more than about 100 minutes a day, counting all their walking, not just deliberate walks, had a lower risk of developing chronic back pain than those who walked less than 78 minutes a day. The amount of walking seemed to matter more than how fast people walked.[5] This kind of study shows a link rather than proving cause and effect.

What about step counts?

The 10,000 steps target is widely quoted, but there is little evidence behind it. A large analysis of 15 studies looked at steps and the risk of dying from any cause. Benefits levelled off at around 6,000 to 8,000 steps a day in people aged 60 and over, and around 8,000 to 10,000 in younger adults.[7] That research was about general health rather than back pain, but it is a useful reminder that a realistic target you can keep up is better than an ambitious one you abandon.

The UK Chief Medical Officers recommend at least 150 minutes of moderate activity, such as brisk walking, each week. They also stress that any increase helps if you are currently inactive.[8] Five 30-minute walks a week, the WalkBack target, meets that recommendation.

How to build up

  1. Find your starting point. Note how long you can walk comfortably now, even if it is only 5 or 10 minutes.
  2. Set a modest goal. For example, three short walks this week at a pace that leaves you able to talk.
  3. Increase gradually. Add a few minutes to each walk, or one extra walk a week. Change one thing at a time.
  4. Aim, over weeks to months, for about 30 minutes five times a week. Splitting this into two 15-minute walks is fine.
  5. Track it. A phone step counter or a simple diary helps you see progress and stay motivated, as it did in WalkBack.
  6. Expect the odd bad day. If your back flares, shorten your walks for a few days rather than stopping.

Practical tips

  • Wear comfortable, supportive shoes and start on flat, even ground.
  • Walk with a friend, a dog or a podcast. It is much easier to keep a habit you enjoy.
  • Build walking into your day: get off the bus a stop early, take the stairs, walk while on phone calls.
  • If you have knee, hip or foot problems, build up more slowly, given that WalkBack saw more leg and foot complaints in the walking group.

If you have lumbar spinal stenosis, walking upright may bring on leg pain, heaviness or tingling that eases when you sit or bend forward. Shorter walks with rests, leaning on a shopping trolley, or using an exercise bike may be easier. If walking distance is steadily shrinking, or leg pain from sciatica is getting worse, see your GP or specialist.

Seek urgent medical help (A&E or 999) if you have:

  • Numbness around the genitals, back passage or inner thighs (saddle area)
  • New difficulty passing urine, or loss of bladder or bowel control
  • Rapidly worsening weakness in one or both legs, or new foot drop
  • Back pain with fever, unexplained weight loss or a history of cancer

These can be signs of cauda equina syndrome or another serious condition that needs emergency assessment.

References

  1. Pocovi NC, 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. Link
  2. Pocovi NC, et al. Effectiveness and cost-effectiveness of a progressive, individualised walking and education programme for prevention of low back pain recurrence in adults: study protocol for the WalkBack randomised controlled trial. BMJ Open. 2020;10(10):e037149. Link
  3. Pocovi NC, 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. Link
  4. Pocovi NC, et al. Walking, cycling, and swimming for nonspecific low back pain: a systematic review with meta-analysis. J Orthop Sports Phys Ther. 2022;52(2):85-99. Link
  5. Haddadj R, et al. Volume and intensity of walking and risk of chronic low back pain. JAMA Netw Open. 2025;8(6):e2515592. Link
  6. Núñez-Cortés R, et al. How much walking is enough for chronic low back pain? A systematic review and dose-response meta-analysis. PM R. 2026 (online ahead of print). Link
  7. Paluch AE, et al. Daily steps and all-cause mortality: a meta-analysis of 15 international cohorts. Lancet Public Health. 2022;7(3):e219-e228. Link
  8. Department of Health and Social Care. UK Chief Medical Officers’ physical activity guidelines. GOV.UK; 2019. Link

This guide is general information and is not a substitute for advice about your own situation. Please speak to your GP, physiotherapist or specialist before starting a new treatment.

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