Walking is good exercise. It is often the main part of an exercise program for people with low back pain (LBP). But if it hurts to walk, back pain sufferers are less likely to follow through with the program.

In this study, physiotherapists examine how LBP affects walking. The goal is to find a way to help them successfully participate in a walking program. We know that people in pain walk more slowly and shorten their stride length. They may do this to decrease the forces on the spine.

To find out more about the effect of pain on force from the ground up to the spine (called vertical ground force or VGF), three groups of patients were studied. The first group had back pain only. The second group had back and leg pain. The third (control) group were healthy adults of the same age and sex as the other two groups. The control group did not have any back or leg pain.

VGF was measured in all three groups at two different walking speeds. The first was their preferred walking speed. The second was their fastest pace. The researchers expected that if speed were kept the same, vertical ground force would be the same for the back pain only and control groups. They also thought the leg pain group would have less vertical ground force when walking at both speeds.

What did they find out? When given the choice, people with back pain walk slower to decrease the vertical ground force. But they can walk faster. When they do, the vertical ground force isn't any higher than for people without back pain.

They also found that people with back and leg pain walk slower but use other ways to reduce vertical ground force through the painful side. They limp and walk in a protective manner. These two factors reduce the loading rate on the leg even when the loading force is the same as the other groups.

The most important finding of this study was the fact that walking decreased pain for the back pain only group. More research is needed to find a way to help patients with back and leg pain. This current study will continue in a second part. Other factors to consider include walking greater distances, shoe type, and walking outdoors.

C. Ellen Lee, PhD, PT et al. Influence of Pain Distribution on Gait Characteristics in Patients with Low Back Pain. In Spine. May 20, 2007. Vol. 32. No. 12. Pp. 1329-1336.