How to Manage Lower Back Pain When Walking, According to Physical Therapists

At Hinge Health, we often say that movement is one of the best things you can do for back pain. And it’s true — staying active is just what your muscles need to heal. But what if walking causes your lower back to hurt? “There’s a lot of motion that happens in your lumbar spine when you walk, which can contribute to pain with movement,” says Julianne Payton, PT, DPT, a physical therapist at Hinge Health. 

The good news: While lower back pain when walking is common, it’s highly treatable so you can remain active with less discomfort. 

And while it may not feel the best to walk when you’re hurting, in most cases, continuing with exercise can actually help resolve the problem. “No matter the cause, lower back pain when walking usually isn’t a reason to stop exercise,” says Dr. Payton. That’s why physical therapists typically recommend targeted exercise and general movement — yes, including walking — to manage lower back pain and prevent future pain flare-ups.

Read on to learn more about what causes lower back pain when walking, along with how to prevent and treat it — especially with exercises recommended by our Hinge Health physical therapists. 

Common Causes 

Several factors can contribute to lower back pain when walking. Some of the most common causes include: 

• Muscle fatigue. One of the most common causes of lower back pain when walking is muscle fatigue. “When you spend a lot of time sitting and not moving much, the muscles along the side of your back that help you stay upright when walking can start to lose a little strength,” says Dr. Payton. With this loss of strength can come some discomfort with walking and other activities. 

• Sprains and strains. If you jump into activity too quickly after an injury or long period of inactivity, or you don’t warm up your muscles before working out, you may over-stretch lower back muscles or tendons (strain) or ligaments (sprain). These injuries can result in inflammation, which may cause pain when you walk. 

• Changes in the spine. Changes in your spine, such as osteoarthritis, spinal stenosis, or issues with your discs, are common and normal with age but they can make it hard to move your body the way you want to, says Dr. Payton. This can result in loss of strength in your lower back and the surrounding muscles and, in some cases, pain when you move.

• Stress. Ever notice your back hurts more when you’re stressed? Stress can affect how you sit and move throughout the day, and you may also move your body less when life is busy, which can contribute to uncomfortable tension and stiffness when you start moving again. Chronic, day-to-day stress has also been shown in studies to impact how you experience pain.

Treatment Options for Back Pain When Walking

If you’re dealing with lower back pain when walking, you can take a few simple steps to decrease your discomfort, including: 

• Warm up before activity. Getting blood flowing in your muscles before movement can go a long way in decreasing pain when you walk. “Try doing a few lower back exercises before you go walking to warm up the area, which can increase blood flow and make walking a bit more tolerable,” suggests Dr. Payton. 

• Take breaks when walking. If your pain is the result of sitting a lot without changing positions, you may be sensitive to movements that cause you to bend backward, also called extension. Because walking involves extension of your lower back, try to take a few breaks where you incorporate the opposite movement, or flexion. Anytime you notice lower back pain when walking, take a break to bend your upper body forward and touch your toes for 10-15 seconds, then continue walking. 

• Try hot or cold therapy. Both hot and cold therapy can help you manage lower back pain when walking. Applying ice can help reduce swelling and inflammation in the lower back, making walking easier. A hot compress can help relax and “warm up” tense muscles, which is also helpful before a walk. 

• Take an over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can be helpful for lower back pain when walking. It’s important to make sure that you are safely able to take these medications, based on your medical history.

Since movement and exercise therapy are an important part of treating lower back pain, all of the above treatments may help make physical activity more manageable — and, in turn, help you feel better, faster.

How to Help Manage Back Pain When Walking

To manage and prevent back pain when walking, try incorporating the below suggestions into your routine. 

• Take breaks from sitting. Sitting for a long time without changing positions can contribute to muscle fatigue, which can cause pain in your lower back when you walk. That’s why Dr. Payton always suggests adding simple movement snacks into your day if you sit a lot. “You don’t need to stand up for 20 minutes to benefit,” she says. “Even getting up to walk or stretch for 30 seconds every 30 minutes is better than sitting the entire time.”

• Stay active. Adding regular exercise to your daily or weekly routine can help strengthen muscles that help you walk, which Dr. Payton says is key to preventing muscle fatigue. Strengthening is also important for stability and injury prevention if you have any age-related changes in your spine. 

• Eat a nutritious diet. Eating a well-rounded diet full of fruits and vegetables and lean protein can ensure your body can benefit from physical activity (especially building muscle strength). Plus, you’ll have more energy when you eat nutritiously, which will help you stick with an exercise routine over time. 

• Keep stress levels in check. Because stress is a known contributor to low back pain, Dr. Payton recommends doing your best to keep your stress levels in check. Whether you incorporate meditation or mindfulness into your routine or talk to a friend or therapist about your struggles, any step you take to reduce stress can also help you feel better physically. 

While any physical activity can help treat and prevent lower back pain when walking, targeted exercises that strengthen and stretch muscles important for walking are the most effective. The above exercises recommended by Hinge Health physical therapists are a great place to start. 

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

PT Tip: Heat Up Before Walking

You may think of applying heat when you’re already in pain, but heat therapy can also prevent pain before activity. Dr. Payton recommends applying a hot pack 10-15 minutes before you go for a walk to aid your warm up, ultimately preventing pain. “It’ll help improve blood flow in your lower back, which can make exercise a lot more tolerable,” she says.

How Hinge Health Can Help You 

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

1. Cho, H., Kim, E., & Kim, J. (2014). Effects of the CORE Exercise Program on Pain and Active Range of Motion in Patients with Chronic Low Back Pain. Journal of Physical Therapy Science, 26(8), 1237–1240. doi:10.1589/jpts.26.1237

2. Choi, S., Nah, S., Jang, H.-D., Moon, J. E., & Han, S. (2021). Association between chronic low back pain and degree of stress: a nationwide cross-sectional study. Scientific Reports, 11(1). doi:10.1038/s41598-021-94001-1

3. Chou, R. (2021, September 20). Patient education: Low back pain in adults (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/low-back-pain-in-adults-beyond-the-basics

4. Dreisinger, T. E. (2014). Exercise in the management of chronic back pain. The Ochsner Journal, 14(1), 101–107. https://pubmed.ncbi.nlm.nih.gov/24688341/ 

5. Viollt, A., & Oshman, L. (2018). For adults with chronic low back pain, is a prescribed walking program as effective as formal physical therapy? Evidence-Based Practice, 21(8), 44–44. doi:10.1097/01.ebp.0000545092.83906.f0