Like anything it would be nice if there were a nice and easy yes or no answer to the question of whether walking is bad for back pain and sciatica. It would seem that even the topic of walking, something so simple, the answer is rather varied. Today we will try to give you a full account on the benefits as well as the hazards when it comes to walking with a back injury. It could be that you’ve a lumbar disc herniation, a minor or major back strain, sciatica or any other formal diagnosis, perhaps degenerative disc disease, spondylolisthesis, the list goes on, but all relevant for today’s discussion.
Can walking be good if you have severe back pain or sciatica?
When in trouble with severe back or leg pain caused by a lower back injury people often struggle to walk, and gravitate to stretches to try to alleviate the strain. Often these stretches, such as knee hugs, or knee rocks left and right lying on the bed might feel good at the time but they are often not in your best interest beyond a few minutes to half an hour.
You might be thinking why they work. Well the simple answer is that they create a change of pressure through movement in the space where the nerves leave the spinal column. If there is inflammation building up here it can lead to pain, creating movement locally can help drain excess inflammation and move things along. This creates an easing sensation, plus, who doesn’t like a good stretch! The problem arises that those movements use what would be considered a large “amplitude” i.e. there is a large amount of movement towards the end of range.
This is where walking comes in, walking to the contrary, will allow for small undulations of the spine, small pressure changes with each passing step and between the steps as our spinal vertebra rock gently on one another, this results in the same effect earlier, of helping drain the area, only without the more extreme movements. Movements which could be stretching already stretched and damaged tissues.
On top of this, you’re upright and mobile, able to perhaps walk to the freezer to get an ice pack to further aid this process, but more on that another time.
The other benefit is that it gets you out of bed and starts gently challenging your core and your posture again, stimulating their engagement so they too can start to provide more protection for the injured region. It is in short an antidote to falling into the trap of bedrest. In years gone by, one thing that often helped the patient that was in extreme pain and unable to move, was the “forcing” of them to come to the clinic for an appointment. Lo and behold, the walking, even though painful and difficult helped get them moving again and although there was still plenty of work to do, the number of times it was notably beneficial for the patient simply to get them up and moving instead of sat or laying down for days on end, was notable time and time again.
Even if it means supporting yourself on the kitchen table, and cruising around like a baby learning to walk by leaning on the sofa, motion is lotion and the enemy of your recovery is bed rest and inactivity.
So you see in this case, the presence of walking is a help for us all with back pain.
Can walking be bad for you when your back pain is bad?
The consideration to the contrary here is that your lower back is a load bearing structure and injuries are a failure to load bear, so this process of being upright will surely be an aggravating one.
This certainly is true, and often the tolerance to standing is limited in the individual with acute back pain, those with more chronic back injuries will often have a more muddy and delayed reaction to too much time walking.
Remember, every night your back will go through a healing process, the trick in the subsequent day is to do enough activity to continue your rehabilitative process and support your bodies recovery, but try to avoid doing too much lest you overwhelm your back and “re-open the wound”.
As we teach in the Back In Shape Program, this comes down to sets and reps, trial and error. You will need to find the timeframe that suits you, if 10 minute walks give you pain try 5 minutes, if 30 minute walks catch you out, try two 15’s. This creativity is required in order to support recovery effectively. Do not be disheartened just because the walk caused pain, be reflective and then adjust – this is much easier to do with sets and reps in the early days or when the back pain is quite severe.
Walking up and down hill with back pain and sciatica
This is a big one, remember we discussed earlier about the knee hugs and knee rocks being high aptitude movements, well compared to walking on flat terrain, going up hill forces a more uneven load and a greater movement in the back, we lean forwards and round our back to counterbalance – it’s 50:50 if it will feel nice or cause pain immediately but it’s always bad!
The reason being that it loads the discs much more so, any sort of disc injury is going to be exacerbated, again, the chronic among you with a slight delay. For those that it feels nice, it is primarily because you’re making those holes where the nerves come out larger as we discussed earlier – again, at what cost.
Going down hill to the contrary is often much more likely to be painful, this is because it forces us to lean backwards, this makes the holes smaller, and brings the facets together. Ultimately although more likely to be painful and acutely-so I would argue that it is not as detrimental. However, think about it, what goes up must come down and if you find yourself going down hill, it’s not going to be long before you find yourself going back up a hill again.
Your best bet is to avoid this sort of walking especially in the early days.
Is walking getting in the way of your back getting better?
One of the great things about walking is it’s a lovely way to spend time in such a varied way, it could be a nice long walk for quiet contemplation, it could be a catch up with friends and family, it could be a walk with your other half, or bonding time with the kids. It is however often misconstrued that walking is somehow helping the recovery process.
Beyond what we mentioned above the utility of walking is limited.
Those that like walking quickly find that it is more of an impediment to their recovery, for two reasons. The first and more relevant, is that it robs you of time you should be doing more impactful rehabilitation, such as your resistance exercises. For example, in the Back In Shape Program, when people start to become more mobile in late Phase Two and Phase Three, they will be tempted to resume these sorts of activities, often at the detriment of consistency when it comes to the specific rehabilitative work. This is furthered if there is the false belief that walking is “good for the back”, not that it is bad for the back but it has no role in the rehabilitative strengthening of your back.
If you feel yourself falling into this trap, be honest with yourself, you can get back to the numerous benefits and joys of walking, but make sure you prioritize the right thing.
The second may not apply to everyone, but for some with back pain, they almost feel like their back is a cup and the strain of the day, being upright, is like a tap that fills that cup to the point of overflowing; Then the pain kicks in. In these early days, if you’re “filling your cup” with walks amongst all the other commitments of the day, you might be finding that you come to do your exercises and you’ve overdone it already and decide… Perhaps tomorrow.
This second case is similar in part to the first, and it’s not just walking that could “fill the cup” so if you feel this is you, try to adjust your day and when you do your exercises to prioritize the actions and practices that are most impactful in moving your back health forwards.
Overall, like many things, walking has a place, and we should take the time to identify precisely what that place is. Ascribing incorrect benefits to walking will only delay the recovery of our back pain, whilst equally avoiding it when it can be valuable in getting us moving again can be equally bad. Do not allow the benefit in one stage to lead to the assumption that more of a good thing is better, as although that can often be the case, in this particular instance it will not be bad per se, but it will take away from more fruitful endeavours.