Published low back pain guidelines offer little advice on which exercises and at what intensity can help prevent low back pain. Although the WalkBack trial found that increasing walking can help prevent a recurrence of low back pain, guideline recommendations remain generic. To address this gap, researchers recently used HUNT Study and Norwegian patient registry data combined with walking duration and intensity data to examine what walking levels are required to reduce the incidence of low back pain. Walking is the most common form of exercise, so this was used to determine if there is a link between exercise levels and preventing low back pain.
The questions the study aimed to answer were:
Does daily walking duration and intensity alter the risk of having chronic low back pain?
Does the amount of sedentary versus active time alter the risk of chronic low back pain?
Does daily walking volume alter the use of back pain related health care?
What they found.
Walking duration: Walking for an hour and 40 minutes per day reduces the likelihood of having low back pain by 23-25% compared to walking 1 hour and 18 minutes per day.
Walking intensity: Walking with a higher intensity, 3.0 MET (Metabolic Equivalent of Task) or above, reduces the likelihood of having low back pain by 15-18% compared to exertion levels less than 3.0 MET. This is approximately 2.5mph (4.0km/h) or 24 minutes to walk a mile without an incline, which is only a moderate pace.
A longer duration of walking had a stronger correlation with reduced low back pain compared to walking intensity. In other words, the amount of time you walk for is more important than the intensity with which you walk for lowering your risk of low back pain.
10,000 steps a day at 2.5 mph and 100 steps per minute will, on average, meet both this duration and intensity of walking. So, yes, walking 10,000 steps a day can reduce your likelihood of developing low back pain.
Sedentary time versus active time: Reducing sedentary behaviour and increasing walking reduces the risk of chronic low back pain.
Seeking healthcare for low back pain: Specialist Healthcare contact is reduced with up to 1 hour and 40 minutes of walking per day.
So, the good news is that you don’t need to walk with high intensity to reduce your risk of developing low back pain, but you do need to walk for at least 1 hour and 40 minutes / 10,000 steps per day. This does not need to be all in one go, it can be spread throughout the day. Even if you cannot walk for this amount of time, reducing the time for which you are sedentary and increasing the amount of time that you are walking will help to reduce your risk of low back pain, but with less probability.
References
Comachio J, Ferreira ML, Mork PJ, Holtermann A, Ho EK, Wang DXM, Lan Q, Stamatakis E, Beckenkamp PR, Ferreira PH. Clinical guidelines are silent on the recommendation of physical activity and exercise therapy for low back pain: A systematic review. J Sci Med Sport. 2024 Apr;27(4):257-265. doi: 10.1016/j.jsams.2024.01.003. Epub 2024 Jan 15. PMID: 38267294.
Haddadj R, Nordstoga AL, Nilsen TIL, Skarpsno ES, Kongsvold A, Flaaten M, Schipperijn J, Bach K, Mork PJ. Volume and Intensity of Walking and Risk of Chronic Low Back Pain. JAMA Netw Open. 2025 Jun 2;8(6):e2515592. doi: 10.1001/jamanetworkopen.2025.15592. PMID: 40512494; PMCID: PMC12166487.
The Hunt Study, Norwegian University of Science and Technology. https://www.ntnu.edu/hunt
Paul Jarle Mork presentation, 12th Interdisciplinary World Congress on Low Back and Pelvic Girdle Pain, Porto, Portugal 2-5/11/2026.
Kongsvold A, Flaaten M, Skarpsno ES, Logacjov A, Bach K, Lund Nilsen TI, Mork PJ. Contribution of walking, running and cycling to moderate-to-vigorous and total physical activity in adolescents and adults across and within seasons: cross-sectional data from the Norwegian HUNT Study. BMJ Open Sport Exerc Med. 2025 Oct 27;11(4):e002394. doi: 10.1136/bmjsem-2024-002394. PMID: 41181313; PMCID: PMC12574398.
Pocovi NC, Lin CC, French SD, Graham PL, van Dongen JM, Latimer J, Merom D, Tiedemann A, Maher CG, Clavisi O, Tong SYK, Hancock MJ. 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 Jul 13;404(10448):134-144. doi: 10.1016/S0140-6736(24)00755-4. Epub 2024 Jun 19. PMID: 38908392.
Saragiotto BT, Abdel Shaheed C, Overton M, Hayden JA, Hartvigsen J, Pinto RZ. Recent highlights in low back pain research, Part II: Prevention and management. J Physiother. 2026 Apr;72(2):106-115. doi: 10.1016/j.jphys.2026.03.002. Epub 2026 Apr 2. PMID: 41933950.
European J of P. Walking for Chronic Pain. Why it matters, What We Know and How to Get Started.
Want Nicholas to take a look?
