A recent study in the Sage Journal talks about walking and its possible benefits for back pain. The study included 52 sedentary patients with chronic lower back pain between the ages 18 and 65. Half of the group walked 20 minutes twice a week, gradually working up to 40 minutes. The other half was assigned to a strengthening program, two to three sessions per week; both groups participated for 6 weeks. According to the study, the walking intervention was almost as effective as the exercise group. (Link to the Sage article http://cre.sagepub.com/content/27/3/207.full)
As a physical therapist, I see that walking is a very important element of treating back pain; one that is often underused. Walking moves the spine, activates core and leg muscles and creates some sense of wellbeing. It is not an option for everyone when impact activities trigger the pain. Hands-on manual therapy in combination with movement education (learning how to move to be safe) is often the best approach to start with. Together with the patient, we set goals such as walking time or distance for the week. The important part is to be consistent.
Walking in water is a therapeutic solution for those of my clients who cannot do much land-based walking as long they don't dislike being in the pool. Walking in the pool builds core and leg strength while unloading the spine. For many the movement education is the most enjoyable part of the therapy since it improves spinal flexibility and allows movement with less guarding and fear.
Learning how to stand tall, stand up from the sitting position, shift weight, turn and walk with less effort is like "coming back into your body," to quote one of my patients. When we become more aware of what healthy movement is like again (as we used to move before injury or sedentary lifestyles took over), we have a stronger foundation to engage in exercise routines and move beyond. Some patients get a pedometer midway in their therapy program to track their number of steps; this can be a motivating tool that helps build stamina. It seems so simple but, surprisingly, this little gadget has helped many of my patients get out there and walk; often to their own surprise they walk further and feel better. After back injuries, walking begins with small steps and short distances, sometimes in the water. When guided by a movement expert/therapist, walking can become a regular part of life again.