How Hiking Can Help Relieve Upper and Lower Back Pain

Nearly 40 percent of Americans struggle with back pain, making it the most common area of the body for aches. While it’s tempting to quit all activity and recuperate in bed with a heating pad, some doctors recommend a different approach for finding relief from back pain: hiking.

If your back is throbbing, you probably won’t feel like doing much of anything, let alone hitting the trails. However, going for a hike during your recovery period and beyond can help accelerate the healing process and even reduce the risk of future issues, according to doctors I interviewed.

I struggled with back pain for years and made the mistake of cutting back on my usual hikes after flare-ups. But my doctor suggested moving more to help reduce pain, along with other lifestyle hacks, and the results have been impressive. I haven’t experienced a major back pain episode in five years.

Back issues are personal, and experts say it’s important to be strategic about using hiking to ease your pain. Here’s what they recommend.

How Hiking Can Help Get Rid of Back Pain

A considerable body of research supports walking as a treatment for back pain. A 2024 study published in The Lancet followed more than 700 adults over a three-year period who had recently experienced lower back pain. Half were assigned to a walking program, with a goal of walking 30 minutes each day, five days a week, while the other half received no intervention, but were allowed to seek outside treatment if they experienced any new back pain during the study. (Researchers believed this to be the most realistic comparison to the group that received the walking intervention.)

The researchers found that individuals in the walking group experienced fewer recurrences of back pain and had longer intervals between back pain episodes compared to those who received no intervention. The differences were striking: people in the walking group had approximately 208 days between back pain episodes, whereas those who made no change to their typical recovery regime typically experienced pain again after 112 days.

Hiking involves walking on uneven ground, which engages more muscles in the back, including small stabilizers, glutes, and the core, to keep you upright.

A 2020 analysis of existing research published in the British Journal of Sports Medicine found that regular exercise, which can include activities such as hiking and walking, is an effective way to prevent recurring back pain. A 2019 systematic review published in the journal Scientific Reports also found that physically active people had the lowest risk of back pain.

That said, most of these studies used sidewalk excursions and treadmill walks as their experimental focus, and walking on a flat road is very different from hiking. Walking of any kind helps to activate the muscles around the spine, which can help to reduce pain for many people, says Dr. David Kennedy, a physician specializing in interventional pain medicine. “In my personal opinion, hiking is even better,” he says.

Hiking involves walking on uneven ground, which engages more muscles in the back, including small stabilizers, glutes, and the core, to keep you upright, Kennedy says. Activating your lower back muscles also engages the core, thus strengthening it, and a stronger core stabilizes the spine. A weak core, on the other hand, increases the risk of spinal misalignment, leading to more pain, he adds.

Todd Miller, associate professor of exercise and nutrition sciences at the George Washington University Milken Institute School of Public Health, says that hiking can also improve balance and your body’s ability to sense its own movements. This can help reduce compensatory movement patterns like limping. If left unchecked, compensatory movement patterns can lead to even more pain in the future by throwing your alignment out of whack, Miller says.

Going up and down hills during hikes can also be helpful. “Uphill hiking challenges postural muscles—including the deepest muscles in your back and pelvis—encouraging a more upright posture while engaging the glutes, hamstrings, and core to reduce excessive spinal loading,” Miller says. “Conversely, downhill hiking requires controlled eccentric movement, forcing the body to absorb impact gradually, which strengthens the legs and minimizes spinal strain.”

One more thing to consider, according to Miller, is that hiking immerses you in nature, which has been linked to lower stress levels. “That calming, stress-relieving effect can reduce the perception of pain by decreasing overall muscle tension,” he says.

What Is the Best Way to Hike to Relieve Back Pain?

If you’re in the thick of a back pain flare, Kennedy says it’s best to wait for the pain to subside a bit before starting your hiking routine. “Once your flare has resolved, staying active and doing core-type exercises, including hiking, helps to reduce recurrent pain,” he adds.

You don’t need to be entirely pain-free to go on a hike, though. “A little pain while you’re doing something is OK as long as when you stop, you go back to your baseline and the pain doesn’t flare up,” Kennedy says. “I don’t want people to go for a mile hike and then be laid up for three days. But if you can hike, have a little discomfort, and don’t need to lie down for the rest of the day, great.”

Wear the Proper Footwear, Stretch, and Monitor Your Posture

For footwear, it’s important to have a deep tread to get a solid grip on uneven surfaces, says Melissa Lockwood, a podiatrist at Heartland Foot and Ankle Associates in Bloomington, Illinois. She suggests investing in shoes with a low heel, between 1/2 inch and 1 inch—her favorites are these waterproof hiking boots. “That will give the muscles in the back of the leg a little bit of an advantage and realign the hip bones, which will ultimately help the lower back,” she says.

Dr. Neel Anand, an orthopedic spine surgeon and director of the Cedars-Sinai Spine Center in Los Angeles, recommends stretching your glutes and hamstrings before going on a hike. Then, move at a pace that feels comfortable to you.

Pay attention to your posture when you walk: that means trying to keep your head stacked over your neck, with your shoulders back (not hunched over), Kennedy says. “Posture matters.”

How Long Should You Hike to Get Relief from Back Pain?

A lot depends on your baseline fitness level, as well as how comfortable you feel, according to Miller. “Start with 30 to 45 minutes on mild terrain, then gradually increase time and difficulty,” he says. “The key is consistency rather than pushing for long distances right away.”

If you find that amount of time is comfortable for you, Miller says you can ramp up hike time to 60 or 90 minutes “as long as you maintain proper form and don’t experience flare-ups.”

Through all of this, it’s crucial to listen to your body. Suppose you’re hiking and you experience pain. In that case, it’s best to back off, says Dr. Mara Vucich, a board-certified spinal surgeon at The Maryland Spine Center at Mercy Medical Center in Baltimore. That might mean slowing down your pace, looking for a flatter surface, or scaling back on the length of your hike and then gradually building it up again, she says.

But Miller doesn’t recommend that you stop hiking right away unless you’re dealing with significant pain. “It often takes several sessions for the body to adapt to the movement demands and for the benefits to become noticeable,” he says. That’s why he suggests hiking two to three times a week for three to four weeks before deciding if it’s right for you. “If pain worsens, consider evaluating factors such as posture, footwear, pack weight, and intensity rather than quitting outright,” he says.

The Best Way to Hike Up and Down Hills When Your Back Hurts

Your hiking form can play a big role in your comfort level, especially if you have upper or lower back pain, according to Miller. However, your posture may vary slightly when walking uphill and downhill, as well as depending on whether you experience upper or lower back pain.

How to Hike Uphill and Downhill When You Have Lower Back Pain

Miller says there’s a specific posture to consider when you have low back pain. “When hiking uphill, it’s important to engage the glutes and core while avoiding excessive arching of the back,” Miller says. “Using a short, steady stride rather than long steps can reduce spinal stress and improve stability.”

When you head downhill, Miller suggests keeping a slight bend in the knees to absorb impact and keep jarring forces from traveling up your spine. “Using trekking poles can also help offload pressure from the lower back, providing additional support,” he says.

How to Hike Uphill and Downhill When You Have Upper Back Pain

If upper back pain is your issue, Miller suggests keeping your shoulders relaxed and avoiding hunching forward when going uphill. Otherwise, you run the risk of increasing tension in your upper back, which can lead to more pain, he says.

“When descending, focusing on controlled movements and avoiding excessive slouching or rounding of the shoulders can help prevent discomfort and maintain proper spinal alignment,” Miller says. It can help to think of pinning your shoulder blades down and back while you hike, and engaging your core to keep your spine upright.

Make Sure Your Hiking Pack Isn’t Too Heavy

Your pack is important for carrying the essentials, but Miller says it’s crucial to wear it properly, especially when you have back pain. He recommends keeping your pack weight to ten pounds or less and trying to distribute the contents’ weight evenly.

“A well-fitted backpack with hip and chest straps [like this one] can help offload pressure from the spine, reducing strain and promoting better posture,” he says.

Miller also suggests placing heavier items closer to the pack’s center for improved weight distribution. (If you’re new to hiking, Miller suggests starting with no pack, if you can, to allow your body to adjust to the movement without extra strain.)

Doctors agree that a hiking habit can be a great way to lower the risk of future back pain flares. “The most important thing for back pain is that you move,” Kennedy says. “If you can get out in nature and hike, that’s even more of a win.”