Continuous versus fragmented walking and walking intensity in relation to perceived myofascial low back pain: a cross-sectional study among Nordic walkers and a rationale for regimen-specific prevention research

Background. Myofascial low back pain (LBP) is among the most prevalent musculoskeletal complaints. Walking is a low-cost, scalable preventive tool, yet the influence of walking pattern (continuous vs fragmented) and intensity on LBP relief is underexplored. Objective. To explore associations between walking regimen (continuous vs fragmented), intensity and other factors and self-reported reduction of myofascial LBP in habitual Nordic walkers, and to define a research agenda for regimen-specific prevention. Methods. Cross-sectional observational study of 60 adults practising Nordic walking, surveyed with a 21-item structured questionnaire (internal consistency Cronbach α=0.78). Three self-reported ordinal pain outcomes were each modelled by proportional-odds ordinal logistic regression (R 4.3.1, MASS::polr) on ten covariates; the between-regimen change in pain was the primary outcome and walking intensity the primary predictor. Results. Higher walking intensity was the strongest correlate of perceived pain reduction (OR=3.60; 95% CI 1.21–11.49; p=0.021). Sixty-five percent of participants in the continuous-walking pattern reported pain relief versus 35% in the fragmented pattern. Conclusions. In this exploratory sample, continuous longer walking and higher intensity were associated with greater perceived LBP relief. The intensity association (OR=3.60), although nominally significant, has a wide confidence interval and arises from a cross-sectional design; it should be interpreted as a tendency that establishes a foundation and rationale for future adequately powered, prospective and randomised studies of walking-regimen parameters for LBP prevention, ideally with objective fascial outcomes (ultrasound elastography).