Walking 100 minutes per day may help lower risk of chronic back pain

For many people, low back pain is chronic, meaning it is constant for at least three months.There are several risk factors for chronic low back pain, such as not getting enough physical activity. A new study found that increasing the length of time and intensity of one's walks may help lower the risk of experiencing chronic low back pain.According to the World Health Organization (WHO), about 619 million people around the world were living with low back pain in 2020. This number is expected to hit 843 million by 2050. For many people, their low back pain is chronic, meaning it is constant for at least three months. And the pain is moderate to intense, affecting their daily lives. There are a number of risk factors for chronic low back pain. Some are not modifiable, such as age, genetics, and underlying medical conditions such as arthritis, spinal infections, spinal stenosis, osteoporosis, and fibromyalgia. However, several risk factors are modifiable, including obesity, improving lifting techniques, smoking, stress, and a sedentary lifestyle.'Low back pain is the leading cause of disability worldwide and accounts for the highest healthcare spending in the U.S.,' Rayane Haddadj, MS, a PhD candidate in the Department of Public Health and Nursing at the Norwegian University of Science and Technology in Norway, told Medical News Today. 'Identifying modifiable risk factors that can be targeted and easily implemented through public health policy and interventions is therefore of great importance.'Haddadj is the first author of a new study recently published in the journal JAMA Network Open that says increasing the length of time you walk, and its intensity, may help lower your risk for chronic low back pain. Walking 100+ minutes per day lowers low back pain riskFor this study, researchers analyzed medical data from more than 11,000 adult participants with an average age of about 55 from the Trøndelag Health (HUNT) Study in Norway, which ran from 2017 to 2019 with a follow-up in 2021 to 2023. At the start of the HUNT study, study participants did not have chronic low back pain. Researchers focused on the daily minutes each participant walked and their walking intensity, or how quickly they walked, which is calculated by using the metabolic equivalent of task (MET) per minute.At the study's conclusion, Haddadj and his team found that participants walking for more than 100 minutes per day were associated with a 23% lower risk of chronic low back pain, compared to those who walked less than 78 minutes per day.78 vs. 100 minutes a day'Our study shows that higher daily walking volume lowers the risk of developing chronic low back pain. The relationship was dose-dependent — meaning the more people walked, the lower their risk — up to about 100 minutes per day, after which the benefit leveled off. Even small increases in daily walking were associated with a decreased risk of chronic low back pain.' — Rayane Haddadj, MSWalking intensity also linked to lower pain riskAdditionally, researchers discovered that walking intensity was also associated with the risk of chronic low back pain, but to a lesser degree than walking volume. 'Our results suggest that a higher average walking intensity is associated with lower risk of chronic low back pain,' Haddadj said. 'However, the association was less pronounced than for walking volume. Further research, including a more robust assessment of walking intensity, could enhance our understanding of its association with the risk of chronic low back pain.''Our results reinforce a growing body of evidence showing that physical activity is essential for long-term health. Even small increases in daily activity can make a difference. Or as the World Health Organization puts it 'every move counts towards a better health'.'— Rayane Haddadj, MS'Walking is a simple, low cost, and accessible activity that can be promoted widely to reduce the burden of low back pain,' Haddadj added. 'Walking more could therefore be a simple yet powerful way to reduce risk of chronic low back pain and other diseases. Future studies investigating parameters such as timing and context of walking could enhance our understanding of the association between walking and risk of chronic low back pain.' Walking more may not always prevent back painMNT spoke with Neel Anand, MD, MCh Orth, a board certified orthopedic spine surgeon and director of the Cedars-Sinai Spine Center in Los Angeles, about this study. Anand commented that while he agrees with the study's findings that activity is better than no activity, he does not agree with the idea that if you walk, you will lower your risk for chronic back pain. 'Walking does not prevent back pain. Walking helps you get better because activity will help back pain always — it actually does. If you have chronic back pain, activity and walking actually makes it feel better than remaining stationary.' — Neel Anand, MD, MCh Orth'But the idea that you walk, you're not going to get back pain, makes no sense at all — that idea is not logical,' Anand continued. 'Back pain is a degenerative disorder. Yes, a couch potato has more chances of getting back pain than a person who's more active — that is correct. But to take that a step further and say, just because you walk, you're not going to get back pain is too far a reach. In my opinion, that's too far a conclusion to make.'

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The Guardian

41 minutes ago

• The Guardian

I was diagnosed with PCOS – and was soon drowning in misinformation

I suspected I had polycystic ovary syndrome (PCOS) long before it was confirmed. The signs were there: the acne scars that littered my back, the irregular periods, the hair in places on my body that I didn't see on many of my friends. I suspected it from the moment that one of my best friends, who as a girl taught me about bleaching my body hair and waxing my legs, was diagnosed with it as a teenager. Admitting all this publicly feels like an unburdening, but also an invitation to more shame. But I write this because my experience is far from unique. As many as one in 10 women have PCOS, a condition associated with hormonal disturbances that can range from weight gain, 'unwanted' body hair and hair loss, to irregular periods and struggles to conceive children (including an increased risk of miscarriage). It can leave women more likely to develop high blood pressure, high cholesterol, diabetes and heart disease. It is not clear what causes PCOS, but it is known to be passed down generational lines and can be influenced by lifestyle. I was finally diagnosed with PCOS last year, at 30, and have been on a journey to understand what that means ever since. The thing that leaped out at me early on (and has since been uncovered by the BBC) is just how much information, and misinformation, exists around the condition. My Instagram feed is filled with medically unqualified influencers. Sorting through all that to figure out which nutritionists and health professionals to pay attention to, in the absence of adequate support from the doctors and nurses who gave me that initial assessment and diagnosis, has been a battle. I've been encouraged to adopt unrealistic diets (so-called 'PCOS nutritionists' often suggest cutting out gluten, dairy and carbohydrates, despite a lack of evidence to show this is sustainable or useful for the condition); take unregulated supplements that can have significant side-effects; and sign up to expensive health plans and apps. I've been told to stop doing cardio and focus instead on weights and walking, because of the misguided idea that high-intensity exercise will cause my cortisol levels to rise to the degree that it will worsen my symptoms. In reality, all types of exercise can be beneficial. Medical misogyny has been well documented, and women's healthcare is rarely taken seriously. I first asked my GP about symptoms during the pandemic, when, after a blood test, I was told that my hormone levels were normal and I didn't have the condition. Later, having an ultrasound for an unrelated matter, I was unceremoniously told that I had lots of follicles on my ovaries and probably had PCOS. When I mentioned the earlier blood test, the sonographer told me that this is not a good way to diagnose the condition, especially if you are using hormonal birth control. Confusingly, PCOS does not cause cysts on the ovaries. 'They're not actual true cysts,' says Helena Teede, an Australian endocrinologist and expert in PCOS at Monash University in Melbourne. 'They're follicles or eggs that are just developing along a pathway, but they stop developing normally because they don't like the hormones that they're floating around in.' There has long been chatter about renaming PCOS to something that is more representative of the breadth of symptoms it causes. The current name, Teede says, 'completely misses the fact that this is a hormonal condition; that it has long-term impacts; that it is psychological, dermatological, metabolic, reproductive and, beyond fertility, it goes into many other reproductive features. And it really has an impact on quality of life.' She says it's likely that the process to give it a new name will be completed this year – her organisation has opened a survey for anyone who wants to contribute. Another myth is that women with the condition have a significant 'excess' of testosterone. And PCOS does open up some interesting questions about gender. But, says Teede, the idea that testosterone is an exclusively male hormone is false. Plus, women with PCOS do not typically have elevated levels of testosterone; it's more that our bodies are not very good at dealing with it. We have much less of the hormone than most men. After my diagnosis at the ultrasound, I had a follow-up call with a nurse practitioner, where I was told simply that I should put up with my symptoms but come back when I wanted to get pregnant; because, of course, that is the only thing that young women aspire to. When I pushed, I was offered a drug named metformin, which is used to treat insulin resistance and diabetes. It wasn't explained to me how this drug works and why it would be useful for my specific case. But, I have since learned, insulin resistance – when your body struggles to regulate your blood sugar levels – is one of the hallmark symptoms of PCOS and triggers a lot of the other issues that people with the condition face. Teede, however, points out that 'every woman has a different problem and a different life stage that's most important to them, and it's about their interpretation'. Doctors should think holistically about treatment plans for women with PCOS and listen to their concerns. My own contrasting experience, though, is much more common, says Rachel Morman, the chair of the UK PCOS charity Verity: 'After 20 years of doing this work, I'm like: 'Why is this still happening?'' She had a similar conversation with doctors after she was diagnosed in the early 00s, with the added shock of being told that she wouldn't be able to have children at all. While it is true that about 70% of women with PCOS experience fertility struggles, after intervention that number drops significantly; the vast majority of women with the condition are able to get pregnant. Morman has three children now. It's also important for women to know that a lot of the risks associated with PCOS in pregnancy (such as miscarriage, gestational diabetes and pre-eclampsia) are preventable. Before they start trying for a baby, women with the condition should have a full diabetes test and get their blood pressure checked, as well as aim for a healthy diet and active lifestyle. But when doctors tell us that PCOS is something we should be concerned about only if we want to get pregnant, that is extremely frustrating, considering the wide range of effects it has on our bodies. Morman says that while there is a lot more information available now than when she was diagnosed, some treatment options have become worse: hair removal treatments used to be offered on the NHS for women diagnosed with PCOS, but not any more. As Teede acknowledges: 'One of the reasons why people go to alternative sources of information is because they're not satisfied with what they get from the health practitioners.' Misinformation about PCOS abounds, and much of it is repeated by medical professionals. To help counteract this, Teede helped to develop the extensively researched international evidence-based guidelines for PCOS in 2023, which I now regard as the holy grail of information about the condition. Her team has also created an app called AskPCOS, which can help women to find the right treatment pathways. It doesn't cover everything, but it is thorough, uses up-to-date research and doesn't make bold claims about 'curing' PCOS, as some people do on social media. 'There are a whole lot of individual practitioners, most of whom are not actually practitioners, who are there for financial gain,' says Teede. 'The biggest challenge I have is the misinformation, and then associated with that, the harm that's done by denigrating actual evidence-based strategies. Which, in the end, does a disservice for women with the condition.' She is not wholly against what she terms 'complementary therapies' (ie supplements and diets), as long as women undertake them clear-eyed and unswayed by false claims. But she does not believe people will stop looking to these types of practitioners for support until there are more trustworthy medical repositories, alongside legal liability for people who provide misinformation. Having researched PCOS over the past year (though there's still much to learn), here's what I've tried: in terms of monitoring the metabolic symptoms, I've checked my blood pressure and had screenings for diabetes and high cholesterol. My levels were fine. I've come off my birth control (some types of pill can help with the symptoms of PCOS; this one didn't) and started taking a well-researched supplement called myo-inositol, which may help with insulin resistance. But I've since come off it because it made me dizzy, a known side-effect for some people. I get periods most months, though I did so before I was put on the pill in my teens, so this may not have affected my ovulation. In terms of cosmetic treatments, I have moved away from laser hair removal, which can cause women with PCOS to experience paradoxical hypertrichosis – the regrowth of darker hairs, seemingly stimulated by the laser. Instead, I have begun electrolysis, the only way to permanently remove hairs. I'm on a break from it as the treatment has been slow and moderately painful, causing breakouts that take weeks to heal. Thankfully, the acne on my face has never been severe, but I have got topical treatment for it from an online dermatologist and benzoyl peroxide from my GP. My body acne has taken longer to get under control; I had a private online consultation with a dermatologist, which cost me £100, and have found reasonably priced skincare products that mostly work for me (shout out to Cerave). The reason I am sharing this is not so that others with PCOS can attempt to mirror my journey. Everyone is different. For example, some women are comfortable with having visible facial hair. It is not inherently shameful and I hate that it is considered to be so. Instead, I am sharing because it shows how much time and energy I have had to put into dealing with PCOS. As it stands, all women with the condition need to go on a journey of evidence-based self-education, because it is unlikely that their primary care doctors will be able to adequately direct them, and there are very few accessible specialists. We have to test out treatments and cosmetic procedures – many unregulated – for ourselves, working through trial and error. Perhaps one of the biggest learnings I've taken from this year has been around mental expenditure. While we undoubtedly have to demand better treatment from our doctors, and ask them to seek out research, those of us with chronic conditions have personal choices to make. Even in an ideal system, where I could be supported on and off medication with all the necessary tests, I would still have to make a judgment call about how much time and energy to invest in 'managing' my PCOS. It is lifelong and incurable, and, for me at least, learning to live with it has become just as important as tackling some of the issues that it causes. That is not to say people with PCOS should give up – learn to embrace their facial hair or uncomfortable acne, or the more serious difficulties related to heart health or diabetes – but it does move it in my mind from a space of hopelessness to one of pragmatism. And it has allowed me to give myself a mental break. 'You do need to have at least four periods a year, because otherwise it's a higher risk of getting cancer of the womb, for example,' says Teede. She says that people with PCOS must go for an annual checkup, including blood pressure tests. 'But you don't need to carry that around permanently,' she adds. The other brilliant news is that, in the background, things are changing. A new study shows that awareness of the syndrome has grown massively in the past eight years. In the UK, there is collaborative work happening to make sure that the syndrome becomes a research priority, including an all-party parliamentary group. 'We'll actually have proper pathways for PCOS treatment, so hopefully that should improve standard of care,' says Morman. For me, I had my foray into the land of misinformation and I battled my way out of it. I have sought out community with other women who have the condition, and I'm taking steps to mitigate its potential effect on my fertility in the future. Most of all, I feel incredibly thankful that I have been diagnosed in an era where there are women like Teede and Morman who are fighting for the recognition and evidence-based treatment of PCOS. We are not at a loss. We are at the bright beginning.

The Independent

an hour ago

• The Independent

Four nurses investigated over death of boy, 5, at flagship children's care home

Four nurses are facing a fitness to practise probe after the death of a 5-year-old boy at a flagship care home for disabled children, The Independent can reveal. The Nursing and Midwifery Council (NMC), the UK's nursing watchdog, initially found there was no case to answer over the death of Connor Wellsted, who suffocated in his cot in 2017 while being cared for at The Children's Trust (TCT) in Tadworth, Surrey. The nurses were referred to the NMC in May 2022, but the watchdog later closed the investigations. It reopened the probe in November 2023 and, this month, after a 19-month-long investigation, decided all four nurses should face fitness to practise tribunals. No interim conditions have been placed on the nurses, meaning they can continue to work while awaiting the outcome. If the committee finds the nurses are unfit to practise, they could be struck off or suspended. However, the committee can also decide that the nurses' fitness to practise is not impaired and give no sanction. It comes after The Independent revealed that Surrey police had reopened a probe into the handling of Connor's death following a litany of failings over the little boy's care. Connor died at TCT, the UK's largest brain injury rehabilitation centre for children, which can care for up to 66 young people, having suffocated when a cot bumper became lodged under his chin. He had been there for six weeks, receiving care for neuro-rehabilitation. He was the first of three disabled children to die while in the care of TCT. Raihana Oluwadamilola Awolaja and Mia Gauci-Lamport died in June and September 2023, respectively. Multiple failings have been identified in all three of the children's care, including a failure to appropriately monitor them. In 2022, coroner Karen Henderson found Connor died after the cot bumper, which was not properly secured, came loose and obstructed his airway. The inquest found TCT 'failed to keep Connor safe in his cot.' Among concerns highlighted by the inquest was the fact Connor had 'no regular or direct supervision during the night'. The inquest also revealed staff did not fully inform the police and coroner's services as to the circumstances of his death. Police were not told of the position Connor was found in, and that he had been dead for some time. They were also not told that the padded cot bumper was initially found across his neck, the inquest heard. The prevention of future deaths report states TCT's chief nurse and medical director were concerned about the role the bumper played in his death, but they did not keep a copy of his medical records or inform the relevant statutory bodies and 'arguably misled' the CQC. The pathologist was also not informed of the circumstances of his death, which prevented a post-mortem examination from taking place to establish whether the cot bumper played a part in how he died, the report said. 'An innocent individual' Last month, Coroner Fiona Wilcox issued a prevention of future deaths report following the death of Raihana. The report found there was a 'gross failure in care by nursing staff' after they failed to adequately observe her. It is not known whether any of the same staff cared for both Connor and Raihana. The inquest also revealed: 'Following Raihana's death, TCT undertook an investigation which failed to uncover what had happened or to understand the cause of her death. This meant that a nurse, to whom Raihana's care had been handed to by the allocated carer was blamed by the TCT and was referred to the NMC erroneously.' TCT said the initial investigation had been carried out by an external organisation. The inquest also found 'issues with the credibility of another nurse (nurse two) who should have been caring for Raihana'. Ms Wilcox warned: 'There may be a culture of cover-up at the TCT, in that they carried out a flawed investigation after this incident, pushing blame onto an innocent individual and thereby avoiding highlighting systemic failures and learning and thus risking lessons that should be learned are lost that could prevent future deaths.' In response to the coroner's allegations about the erroneous referral to the NMC, TCT said: 'We accept that the initial external investigation was inadequate and did not sufficiently explore systemic factors. 'We later identified these issues and undertook further work to strengthen our organisational learning. The extensive evidence presented to the coroner during the inquest helped clarify the events that led to Raihana's death and enabled us to improve the way we manage and investigate incidents. 'Raihana's death has prompted significant reflection, change, and action across our organisation. We are working hard to build a no-blame culture and support our specialist staff to meet our high standards of care. We've made significant changes to how we review and respond to concerns - focusing on learning, not blame.' It said it has implemented the Patient Safety Incident Response Framework (PSIRF), 'which shifts the emphasis from individual fault to understanding wider systemic issues'. The NMC was sent a copy of Raihana's prevention of future deaths report. In a response to The Independent, it said: 'We are aware of the tragic deaths of Connor, Raihana and Mia and our thoughts are with their loved ones. 'We can confirm that we have received the prevention of future deaths report in relation to Raihana's sad death and are considering the appropriate next steps. 'We are only able to confirm whether an individual is under investigation in certain circumstances, which is generally if we have completed an investigation and case examiners decide there is a case to answer.' The NMC confirmed that, in the case of Connor, its case examiners have decided there is a case to answer concerning four registrants and have recommended they proceed to a fitness to practise committee. The NMC has faced criticism over the screening and decision-making of referrals.

Daily Mail​

2 hours ago

• Daily Mail​

Kate Lawler, 45, reveals battle with secret health condition that left her 'in the worst pain of her life' before being rushed to hospital in Greece

Kate Lawler has revealed her battle with a secret health condition that left in 'the worst pain of her life.' The Big Brother star, 45, has shared in a new interview how she battled debilitating stomach pain, and was eventually rushed to hospital in Greece, before being reassured by doctors that 'everything was fine.' Kate told The Sun On Sunday that it took rounds of tests and several misdiagnoses back in the UK before doctors finally discovered she had pelvic congestion syndrome, a little-known condition caused by hidden varicose veins around the ovaries and womb. She revealed: 'It was a sharp, stabbing pain that would last from 10 seconds to several hours. 'Then we were on holiday in 2018 and I thought I had a serious hernia or something was wrong with me, to the point that I went to hospital. 'But doctors thought I was just going mad. They just said, 'You're fine,' and left it at that. I was made to believe it was simply caused by my hormones, or ovulation.' Kate, who shares daughter Noa, four, with husband Martin Bojtos, added that she visited her GP twice, and was instead told it could be a hernia or endometriosis, and even a visit to a private gynaecologist failed to provide answers. She went onto reveal that it was during a chance conversation at a routine appointment for her varicose veins in August 2022 that she discovered she had PCS. The condition is most common in women aged 20 to 45 who have given birth more than once, as well as those with varicose veins, a family history of them, or polycystic ovary syndrome. Patients can experience dull or heavy pain in their pelvis, and it can feel worse at worse at the end of the day, before or during your period, or during or after sex. While many Brits have never heard of PCS, it affects around 1.5million people in the UK, and Kate said that a visit to The Whiteley Clinic helped her get tested for the condition. The reality star added that varicose veins have run in her family, and they and PCS are 'often interlinked.' Treatment for PCS is typically pelvic vein embolisation - a procedure which involves placing tiny coils inside the damaged veins under X-ray guidance, and Kate said the procedure has changed her life. The star said the procedure was 'uncomfortable but not painful,' and called for doctors to have more awareness of PCS. WHAT IS PELVIC CONGESTION SYNDROME? Pelvic congestion syndrome (PCS) leads to chronic pain in the pelvis, which is thought to be caused by problems with the veins in that area. Such vein problems may cause blood to build up, making them enlarge and change shape, like varicose veins. Pregnancy and childbirth may trigger PCS, however, its exact cause is unclear. PCS' patients' pain may be worse during sex, after standing for a long time and when walking. Other symptoms may include discomfort during periods, a sudden need to urinate and enlarged veins on the buttocks, genitals or thighs. Treatment may involve drugs to relieve pain or block ovarian function. Surgery can removed damaged veins. A hysterectomy may also be required. It comes after Kate revealed she has 'broken the law' as she ended up locked in a dispute with her neighbour. The Big Brother winner took to Instagram to share that she had got herself into 'trouble' with her neighbour after painting the back of their shed. Kate revealed that her gardener had painted it because because she didn't like the colour of it, but her neighbour was furious she had done so without permission and the TV personality later discovered it was in fact illegal, and considered trespassing. She quickly took to social media to explain her predicament and sparked a nationwide debate as some agreed with her that they wouldn't care, while others were horrified that she had painted someone else's property. 'Why do I always get myself in these situations?' Kate wrote. 'I'm in trouble with my neighbour for painting the back of their shed a different colour. Won't be doing it again as in hindsight I know I should have asked first, but I didn't think it would be a big deal given that they can't see it? 'It has made me wonder though… Would you be annoyed if you discovered the back of your shed (which you couldn't see) had been painted by the neighbour whose garden backed on to yours? 'Have you had a similar fall out with your neighbour? Basically, am I an a***hole and should I buy them flowers and a box of milk tray to apologise?' The next day Kate again took to social media to reveal she had since discovered it was illegal. 'I've just found out I've broken the law,' she began. 'Um... I found out that me painting someone's shed is actually illegal. I can't believe I didn't know this. Genuinely I did not know that me leaning over the end of my garden, sorry not me my gardener, that him leaning over the end of our garden and into somebody's else's garden and painting the back of their shed is trespassing. 'Um... so I'm sorry if that offends you and I'm sorry to my neighbour because I didn't know that what I was doing was illegal and I also, genuinely, I just didn't think someone would mind me painting the back of their shed which they couldn't see and I know that a lot of you would. 'And that's what's so interesting about this debate because it has sparked a nationwide debate.' She continued; 'Half the people in the comments of my last video wouldn't care either. I genuinely wouldn't care if somebody paint. In fact if you want to paint the back of my shed go for it, it just wouldn't bother me. 'We're all different, we're all human beings, none of us are the same. Some of you would care, some of you wouldn't. That was the question I was asking more. I'm not asking if what I did was wrong. I know what I've done was wrong, I know it was illegal, now, I didn't know it at the time otherwise I wouldn't have done it but I'll never do it again. 'So don't be like me. Don't paint the back of somebody's shed without asking first because it is illegal, it is trespassing. And what a debate! It is quite fascinating. Anyway... I'll leave it there.' Kate also captioned her video: 'WARNING! Do not lean into your neighbours garden and paint the back of their shed / fence or anything as it's actually illegal. It's considered trespassing or vandalism, which I genuinely didn't realise I at the time. 'So like I suggested in my previous video, I'm going to buy them a sorry present and apologise. Sorry if I offended you in my actions too. 'Just remember what Albert Einstein once said…. The man who never made any mistakes never made anything x.'