Once upon a time, far from advocating a good brisk walk, the standard treatment for pack pain was bed rest. Lots and lots of bed rest. So much so that a study from 1992 started with the observation that the recommended treatment for lower back pain varied from two days to two weeks. Interestingly that study found that in ‘relatively young and motivated patients’ there was little difference in outcome between three day’s and seven day’s bed rest. As such the study concluded that shorter durations are preferable, bringing as they do psychological and economic benefits.

Fast forward to current times and the latest thinking is that for many types of back pain, rather than bed rest, exercise is best; as long as it is the right type of exercise. For example, an Australian study from 2024 called WalkBack looked at the effects of individuals undertaking a progressive walking, education and physiotherapy programme.

The results showed that, whilst the programme didn’t completely eliminate back pain, those on the programme experienced a substantial reduction in low back pain recurrence as compared to those in the control group. It further concluded that “By encouraging active self-management using health coaching principles, the WalkBack intervention might be able to reduce the prevalence of recurrent low back pain and associated burden on health-care systems.”

The results of this study and others like it demonstrate the important role which physiotherapists and other health professionals can play in re-mobilising individuals who have been suffering from work-limiting back pain. Add in the benefit of education in helping people to understand how exercise, even a gentle walk, can help to prevent back pain from occurring in the first place and it is easy to see how a combination of prevention and intervention through walk and exercise programmes could not only help to boost individual health outcomes but also benefit the workforce and greater society as a whole.

To this end, the NHS has just entered an agreement with Nuffield Health to offer the Nuffield’s Joint Pain Programme to NHS employees in certain areas of the country. The six-month programme offers a combination of lifestyle advice, exercise and rehabilitation. Lifestyle topics covered include pain management, eating well, and mental health, whilst the exercise programme looks at a combination of strength, flexibility and stability training as well as yoga.

 Within the NHS, back and musculoskeletal problems are the second highest cause of absence, leading to over 314,000 lost days in the past year. It is not surprising therefore that the NHS see this programme as a potential game changer. Commenting on the new partnership, Health and Social Care Secretary West Streeting said: “NHS staff cannot treat patients if they’re in debilitating pain themselves. This partnership with Nuffield Health will help get thousands of NHS staff back to work, improve their quality of life, and allow them to continue to cut waiting lists.”

It’s a bit like the old saying ‘physician heal thyself.’ It doesn’t matter what contribution an individual is making within the health sphere. From answering phones and booking appointments to delivering hands on health treatments every individual has their part to play. And if they can do so while they themselves are pain free, they have the potential to help so many others to also live in a pain free manner.