Back Pain When Walking: Is It Time to See a Doctor?

For individuals with lower back pain when walking, could they have injured a muscle or have an underlying condition affecting the joints, ligaments, or nerves?

Back Pain When Walking

Lower back pain when walking can occur for a variety of reasons. It can result from poor posture, injuries, muscle fatigue, or an underlying condition. Specific injuries, like muscle strains, can affect the ligaments in the spine and cause pain. Muscles that have not been used often can result in fatigue and pain. Specific health conditions, such as degenerative disc disease, spinal stenosis, herniated discs, sciatica, or even sacroiliac joint dysfunction, can cause lower back pain. Factors like overexertion or improper gait can exacerbate it.

Muscle Issues

Muscle strains, ligament sprains, or fatigue can cause lower back pain when walking. Pain can occur after walking or come on gradually from wear and tear without an apparent cause, as follows (American Association of Neurological Surgeons, 2024)

Strains

• Occur when the fibers in the back are overstretched or torn.
• Pain from muscle strains is usually worse during activity and better when resting.

Sprains

• It occurs when the ligaments that connect bone to bone become detached.
• If the muscles do not adequately support the spine, the spinal joints absorb more pressure, which can lead to injury to the spinal ligaments.

Fatigue

• It can happen from overexertion and lead to lower back pain when walking.
• It could occur when walking longer than the body is used to, on uneven surfaces that make the muscles work harder to help maintain balance, or climbing hills that cause you to lean forward while walking.

Degenerative Disc Disease

• Between each vertebra is a disc that provides cushioning between the bones.
• As the disc wears down, surrounding muscles, ligaments, joints, and nerves in the spine absorb more pressure, causing damage.
• Degenerative disc disease is a wear-and-tear condition that becomes more common as individuals age and is a common cause of lower back pain.
• Healthcare providers recommend walking as a low-impact activity for individuals with the disease. However, if the condition is more severe, individuals could experience pain from this exercise, especially when walking on hard surfaces. (Hospital for Special Surgery, 2024)

Sciatica

Sciatica pain occurs when a nerve exiting the spine in the lower back becomes compressed or pinched. It is a common symptom of a herniated disc, in which a disc moves out of place and puts pressure on nearby nerves. In addition to lower back pain, sciatica can cause pain in the hip, the back of the thigh, and down the leg. Sciatica can also cause: (American Academy of Orthopaedic Surgeons, 2021)

• Numbness
• Tingling
• Muscle cramps
• Leg muscle weakness

Healthcare providers often recommend walking as a safe form of physical activity for individuals with sciatica. However, individuals should avoid twisting or bending forward. (American Academy of Orthopaedic Surgeons, 2021) To decrease pain, avoid walking on uneven surfaces or uphill.

Lumbar Spinal Stenosis

• Spinal stenosis is a wear-and-tear condition that often affects the lumbar spine/five vertebrae in the lower back.
• It causes the space surrounding the spinal cord to narrow.
• Sometimes, the narrowing can add pressure on the nerves, resulting in numbness, tingling, and weakness in the legs. (American Academy of Orthpaedic Surgeons, 2021)
• Lumbar spinal stenosis typically causes pain when standing upright, including when walking.
• Many with this condition find that leaning slightly forward helps to reduce the pain by opening up the compressed areas.

Hyperlordosis

Lordosis describes the normal curve in the spine in the lower back. However, when this curve is exaggerated, it causes hyperlordosis or swayback. (American Academy of Orthopaedic Surgeons, 2020) Hyperlordosis affects the range of motion, putting abnormal pressure on the muscles, ligaments, and joints. It also reduces the spine’s ability to absorb shock correctly when walking, leading to pain. (Cedars-Sinai, 2025)

Prevention Strategies

Individuals can take steps to reduce their risk of lower back pain when walking, even if they’ve been diagnosed with a condition that can potentially cause this symptom. Walking can decrease chronic low back pain for some. (Suh J. H. et al., 2019) As with any new exercise program, check with a healthcare provider to ensure that walking for exercise is appropriate for the injury, condition, or disease and is safe. Recommended tips: (Harvard Health Publishing, 2015)

• Wear shoes made for walking.
• Perform gentle lower back stretches before walking.
• Start slowly by walking for a few minutes, then gradually increase the time.
• Walk on a smooth surface, such as a sidewalk or athletic track, or indoors, such as in a shopping center or mall.
• Warm up and cool down by walking slowly at the beginning and end of the walk.
• This allows the back and leg muscles to warm up before exercise and recover afterward.
• Walk at a slow to moderate pace/speed that allows one to converse.
• Standing up straight while walking or standing upright reduces pressure on the lower back.

Alternative Exercise

If there is still back pain when walking, it might not be an appropriate exercise for the individual and/or how their condition presents symptoms. Alternate activities can include: (Hospital for Special Surgery, 2023)

Elliptical Trainer

• This exercise keeps the feet in contact with the pedals, putting less shock-absorbing pressure on the spine than walking.

Recumbent Biking

• will keep the back upright, which is recommended if there is more pain when bending forward.

 Upright Stationary Biking

• This is recommended if the back pain improves when bending forward.

Walking In A Pool

• This activity provides benefits while reducing pressure on the spine.
• To target different muscles, try walking laps in waist-deep water in multiple directions (forward, backward, and side to side).

Water Aerobics

• This activity provides cardiovascular health benefits with decreased pressure on the back.

Injury Medical Chiropractic & Functional Medicine Clinic

See a physical therapist for a personalized exercise program to reduce back pain and appropriate for your condition. Injury Medical Chiropractic and Functional Medicine Clinic works with primary healthcare providers and specialists to develop an optimal health and wellness solution. We focus on what works for you to relieve pain, restore function, and prevent injury. Regarding musculoskeletal pain, specialists like chiropractors, acupuncturists, and massage therapists can help mitigate the pain through spinal adjustments that help the body realign itself. They can also work with other medical professionals to integrate a treatment plan to resolve musculoskeletal issues.

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Beyond Adjustments: Chiropractic and Integrative Healthcare

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References

American Association of Neurological Surgeons. (2024). Low back strain and sprain. www.aans.org/patients/conditions-treatments/low-back-strain-and-sprain/

Hospital for Special Surgery. (2024). Degenerative disc disease. www.hss.edu/condition-list_degenerative-disc-disease.asp

American Academy of Orthopaedic Surgeons. (2021). Sciatica. orthoinfo.aaos.org/en/diseases–conditions/sciatica

American Academy of Orthpaedic Surgeons. (2021). Lumbar spinal stenosis. orthoinfo.aaos.org/en/diseases–conditions/lumbar-spinal-stenosis/

American Academy of Orthopaedic Surgeons. (2020). Spine basics. orthoinfo.aaos.org/en/diseases–conditions/spine-basics/

Cedars-Sinai. (2025). Swayback (lordosis). www.cedars-sinai.org/health-library/diseases-and-conditions/s/swayback-lordosis.html

Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. doi.org/10.1097/MD.0000000000016173

Harvard Health Publishing. (2015). 5 tips for getting started with a walking program. www.health.harvard.edu/exercise-and-fitness/get-started

Hospital for Special Surgery. (2023). Best types of exercise for back pain. www.hss.edu/article_best-exercise-lower-back-pain.asp