5 Reasons Walking Makes Your Lower Back Pain Worse

Quick Overview

Walking can worsen lower back pain, especially for those with conditions like stenosis or herniated discs, because it often fails to address underlying muscle imbalances or coordinate movement patterns correctly, leading to increased compression over time if the glutes and core are not firing properly.

Key Points: Walking does not offload the spine; instead, it can add compression if underlying issues exist (0:52). For conditions like herniated discs or sciatica, walking can exacerbate the problem by adding compression when the core and glutes are weak or improperly coordinated (1:00, 2:53). Walking is a highly recommended exercise generally, but for specific back pain issues, it can be counterproductive if movement patterns are task-oriented rather than procedure-oriented (0:06, 3:23). The video identifies five reasons walking might worsen back pain, focusing on muscle imbalance and poor coordination during the gait cycle (0:51). When glutes and core stabilizers are not firing correctly, the body compensates by overusing back muscles and hip flexors, increasing spinal compression (6:06, 7:49). If you have a disc injury, the stabilizing structures (annulus fibrosus) are loose, and excessive motion from walking can make it worse (5:15). The solution involves strengthening the core and glutes and ensuring proper coordination before relying on walking for exercise (6:38, 8:29).

Context: Dr. David Middaugh, a Manual Physical Therapist, explains why the commonly prescribed exercise of walking may be detrimental for individuals suffering from chronic lower back pain conditions such as stenosis, degenerative disc disease, or herniated discs. He argues that while walking is generally healthy, it can aggravate existing spinal instability and muscle imbalances if the underlying mechanics are not addressed first.

Detailed Analysis

Dr. David Middaugh outlines five key reasons why walking, despite its general health benefits, can exacerbate lower back pain, particularly for those with existing spinal issues like stenosis or herniated discs. The first reason (0:52) is that walking does not offload the spine; rather, it can increase compression when underlying structural issues exist, such as a loose disc or pinched nerve (5:01). The second reason (1:45) highlights that coordination matters greatly; the way the body uses different muscles (legs, hips, upper body) during the gait cycle must be correct. If the coordination is poor, the body compensates by using the wrong muscles at the wrong time, adding compression over time (1:27, 2:53). The third point (3:51) is that walking makes people focus more on endurance and cardio rather than the necessary strength and coordination required to fix the muscle imbalances in the back and core (3:55, 6:03). The fourth reason (4:32), related to the third, is that if you walk for long distances without addressing muscle imbalances (weak glutes/abs), you are continually feeding the problem (4:50). Finally, the fifth point (5:41) relates to muscle imbalance itself: if the glutes and core are not firing correctly, the body compensates by overusing the back extensors and hip flexors, which increases compression on an already vulnerable spine (6:09, 7:49). Dr. Middaugh uses a spinal model to illustrate how an injured disc (represented by the red/yellow components) becomes loose, and excessive motion from walking aggravates this instability (4:57). He concludes that individuals should focus on fixing the muscle balance and coordination first, suggesting specific strengthening exercises listed on a nearby whiteboard (like bridges, clamshells, etc.), before increasing walking duration or distance (6:38, 8:29).