The Effects of Walking on Low Back Pain
What is Low Back Pain ?[edit | edit source]
Low back pain that is not associated with serious or potentially serious causes has been described in the literature as 'non-specific', 'mechanical', 'musculoskeletal' or 'simple' low back pain.[1] Non-specific low back pain is defined as low back pain not attributable to a recognisable, known specific pathology (eg, infection, tumour, osteoporosis, fracture, structural deformity, inflammatory disorder, radicular syndrome, or cauda equina syndrome).[2]
Lower back pain can be further split into three categories; acute, sub-acute and chronic.[3]
- Acute is anything that persists less than 6 weeks.
- Sub-acute is anything persisting between 6-12 weeks.
- Chronic is anything persisting for 12 weeks or more.
Lower back pain is commonly described to be between the anatomical regions of the ribs and gluteal folds.[4]
The lumbar spine comprises the lower end of the spinal column between the last thoracic vertebra (T12) and the first sacral vertebra (S1). There is a total of five lumbar vertebra (L1-L5) that are much larger compared to other regions within the vertebral column. These large facets help support the upper body ,as they absorb axial forces (against gravity) delivered from the head, neck and trunk, and provide protection for the spinal cord from the canal that is formed. The lumbar spine allows for diverse types of trunk motion, including flexion, extension, rotation, and side bending, thus providing further reasons as to why the facets are much larger. Each lumber facet consists of multiple components; vertebral body, transverse process, super articular process, super articular facet, intervertebral disc, vertebral forearm, pedicle of vertebral arch, lamina of vertebral arch and a spinous process.[6]
Epidemiology[edit | edit source]
One study that was carried out in 195 countries assessing the incidence, prevalence, and years lived with disability for 354 medical conditions found low back pain to be the leading cause of worldwide productivity loss as measured in years, and the top cause of years lived with disability in 126 countries.[7]
The prevalence of low back pain increases with age, with rates of 1%–6% in children aged 7–10 years, 18% in adolescents, and a peak prevalence ranging from 28% to 42% in people between 40 years and 69 years.[7]
Low back pain causes more disability than any other condition, affecting 1 in 10 people and becoming more common with increasing age.
In the UK it is estimated that low back pain is responsible for 37% of all chronic pain in men and 44% in women and the total cost of low back pain to the UK economy is reckoned to be over £12 billion per year.
Pedometer Driven Walking[edit | edit source]
Pedometers are a device which works by counting the steps someone takes to estimate the distance they have travelled.[8] ADD WHERE PEDOMETERS ARE WORN - CHECK INDIVIDUAL INSTRUSTIONS ON EACH.
TO INSERT PICTURE OF PEDOMETER - TAKE OWN PICTURE
Whilst not a pedometer in the traditional sense, the NHS (National Health Service) also have an app which is free to download called 'Active 10' - this is designed to track walking and will indicate the total amount walked and how much of that was brisk walking. [9] Within the app there are also options to set goals, achieve milestones and view progress over the weeks and months. [9] So a pedometer is not the only option to keep a track of walking and daily activity - there are many more apps out there!
Do Pedometers Increase Activity?[edit | edit source]
Pedometers and Goal Setting[edit | edit source]
Pedometer Effects on Low Back Pain[edit | edit source]
Walking Effects on Low Back Pain[edit | edit source]
Treatment and Management[edit | edit source]
The Department of Health and Social Care recommend that adults take part in at least 150 minutes of "moderate level" activity weekly (reference).
- Examples of "moderate level" activity is anything that increases the heart rate and breathing rate, such as brisk walking, cycling or mowing the lawn.
Walking is a good low-impact exercise for patients with lower back pain to begin increasing their levels of physical activity.
Management strategies[edit | edit source]
The use of a pedometer means that the patient is able to manage and keep track of their steps whilst walking. The patient might be advised to keep an "activity diary", as shown below, which keeps track of a daily step count and the patients' step goal.
Insert example of activity diary
The use of an activity diary can also help establish the patients' baseline in the first week, which is important in informing their individual goals for rehabilitation (reference). This is achieved by calculating the patient's average step count in the first week of activity, and using this as a baseline when deciding a step goal for the second week.
Outcome measures[edit | edit source]
Goal setting[edit | edit source]
Suggestions for Future Clinical Research[edit | edit source]
References[edit | edit source]
- ↑ NICE Guidelines (2016). Context | Low back pain and sciatica in over 16s: assessment and management | Guidance | NICE. [online] Nice.org.uk. Available at: https://www.nice.org.uk/guidance/NG59/chapter/Context [Accessed 12 May 2022].
- ↑ Balagué, F., Mannion, A.F., Pellisé, F. and Cedraschi, C. (2012). Non-specific low back pain. The Lancet, 379(9814), pp.482–491. doi:10.1016/s0140-6736(11)60610-7.
- ↑ Burton, A.K., Balagué, F., Cardon, G., Eriksen, H.R., Henrotin, Y., Lahad, A., Leclerc, A., Müller, G. and van der Beek, A.J. (2006). Chapter 2 European guidelines for prevention in low back pain. European Spine Journal, 15(S2), pp.s136–s168. doi:10.1007/s00586-006-1070-3.
- ↑ Dixit, R. (2017). Chapter 47 - Low Back Pain. [online] ScienceDirect. Available at: https://www.sciencedirect.com/science/article/pii/B9780323316965000474 [Accessed 12 May 2022].
- ↑ Heywood, C. (2015). Will my low back pain get better? | Physiotherapy | Team Rehab uk. [online] Physiotherapy | Back Pain | Sports Injury | Rehabilitation | Corby & Moulton, Northants. Available at: https://www.teamrehab.uk/lower_back_pain_northampton_corby_moulton.html [Accessed 13 May 2022].
- ↑ Sassack, B. and Carrier, J.D. (2020). Anatomy, Back, Lumbar Spine. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557616/.
- ↑ 7.0 7.1 Knezevic, N.N., Candido, K.D., Vlaeyen, J.W.S., Van Zundert, J. and Cohen, S.P. (2021). Low back pain. The Lancet, 398(10294). doi:10.1016/s0140-6736(21)00733-9.
- ↑ OED Online. Pedometer, n. [online] Available from: https://www.oed.com/view/Entry/139645?rskey=SBOh5n&result=2&isAdvanced=false#eid (accessed 15th May 2022)
- ↑ 9.0 9.1 NHS. Get active - Better Health [online]. nhs.uk. 2020. Available from: https://www.nhs.uk/better-health/get-active/ (Accessed 15th May 2022)
