In the first study of its kind, new research has shown that incorporating some running or jogging into a walking program is an acceptable form of exercise for many people who suffer from chronic lower back pain. Traditionally, this higher-impact exercise has been advised against, in favor of activities like swimming, cycling and, of course, just walking.
While jogging and running is widely considered to be beneficial for healthy people to maintain spine health, little research has looked into whether it can benefit those who already have back issues.
The study, led by Monash University in Australia, recruited 40 people aged 18-45 (mean age 33 years) with non-specific lower back pain and assigned them either a 12-week run-walk program or put them on a 'waitlist,' during which they continued their usual activities (the control group).
The interval-training program consisted of three, progressive 30-minute sessions per week, which were tailored and sent to participants digitally, and remotely supported by an exercise physiologist. At the end of the trial, both cohorts self-reported their pain levels with the Visual Analogue Scale (VAS) for Pain, which ranges from 0-100 points. They also filled in the Oswestry Low Back Pain Disability Questionnaire (or Oswestry Disability Index, or ODI), an important clinical tool for gauging how this chronic condition impacts one's quality of life.
The study's program, which slowly progressed throughout the 12 weeks, featured short intervals of running mixed in with walking. At the start, the running intervals were just 15 seconds, and gradually progressed to up to three minutes, depending on the individual's ability and tolerance. Walking intervals were reduced as the participants' running ability was built up.
Additionally, each participant in the program had a two-minute run assessment prior to the trial, and were given an exercise guide based on this – from those who could only run for a few seconds, to those who could handle 90-120 seconds. During the trial, participants only moved to the next stage of difficulty (more running and less walking), if they were tolerating their sessions well and had been consistent. On the flip side, workout levels were eased for those who experienced any increase in pain or discomfort.
At the end of the study, the run-walk cohort reported an average reduction in pain of 15.3 points on the VAS scale and a 19.35 point drop when asked to report their current pain intensity, while the control group remained at baseline.
The run-walk group also saw an improvement in their ODI score, with a mean 5.2-point change. While not massive, this indicates a helpful change in everyday function while living with their lower back pain.
Nine non-serious adverse events were reported, relating to lower limb pain or injury, but all participants resumed training after recovering; overall, there was 70% adherence to the program, with everyone finishing the 12 weeks, however, there was an average of 2.1 sessions per week.
While the results were promising, the researchers acknowledge that not everyone has the ability to run, and caution that undertaking any new physical activity to combat lower back pain (LBP) needs close medical supervision.
"To minimize the risk of injury or pain ‘flare’, we recommend individuals with non-specific chronic LBP work closely with a suitably qualified health professional (eg, an exercise physiologist or physiotherapist) when returning to running or commencing a new exercise training program," they noted in the study.
Also, the study did not statistically reach 'clinically meaningful' scores in VAS or ODI results, but the improvements do suggest that this kind of closely monitored, tailored run-walk program is an acceptable form of physical activity for chronic, non-specific back pain sufferers.
More research and longer-term studies into the impacts of interval training are needed.
The research was published in the British Journal of Sports Medicine.
Source: Monash University via British Journal of Sports Medicine