Everyone knows the power of a good walk – that wonderfully invigorating blast of fresh air and the feeling of satisfaction and wellness as you kick off muddy boots. So why don’t we do it more often?
With decades of clinical practice between us – one of us is a chiropractic physician, the other a Doctor of Physiotherapy – we believe the simple act of walking may well be our modern world’s most under-prescribed medication.
It’s so potent we call it ‘Vitamin W’ – and regular ‘doses’ form the basis of our mobility plans for our patients.
Putting one foot in front of the other – across a field, or in a city street – is the key to good health, as essential as breathing, sleeping and eating.
Did you know that walking, even for a short time each day, benefits your whole body? It helps everything from heart function to bone strength, weight control, sleep, mood and even stress.
Studies show that small amounts of regular walking – far less than the 10,000 steps a day so many people think they must clock up – can reduce the risk of developing serious diseases including some cancers and dementia.
But what might surprise you is that walking is also the best medicine for treating many types of pain.
That may seem counterintuitive. If you’ve ever had a sore leg, an injured hip or knee or lower back pain, the chances are you’ve been told to rest. But new research shows that not only does rest not work in such cases, it may actually delay your recovery.
Recent research involving 95,000 people found that walking more than 5,000 steps a day (roughly two and a half miles) can help to reduce depressive symptoms
Meanwhile, numerous studies have shown that a gradual but regular regimen of walking can be a powerful strategy for managing and reducing pain.
Regular walking helps your body to heal by reducing blood pressure and heart rate over time.
It also improves the psychological elements of pain by triggering the release of more ‘feel good’ endorphins, which improve mood, as well as helping to regulate elevated stress hormones.
The release of ‘feel good’ chemicals can explain why walking is an effective way to improve stress, something that three out of four adults report is negatively impacting their health.
Constantly elevated levels of stress hormones are destructive to the body and are linked to a wide range of diseases long term: regular walking increases serotonin and dopamine, both associated with producing a happier, more positive frame of mind, which is why it’s often dubbed ‘muscular meditation.’
Recent research involving 95,000 people found that walking more than 5,000 steps a day (roughly two and a half miles) can help to reduce depressive symptoms. Increasing this to 7,000 steps a day could reduce your overall risk of developing depression.
Regular walks in nature have also been shown to form new neural pathways in the brain, promoting mindfulness and mental clarity.
One thing to make sure of, though, is that you are wearing the right size shoes. Unbelievably, almost two-thirds of adults – some 60 per cent – have been found to be wearing ill-fitting shoes in the wrong size. We regularly see patients in pain and struggling to walk because of it.
This piece is adapted from a new book by Courtney Conley and Milica McDowell
How does this happen? As we go through life, there are many reasons why our feet can change. Pregnancy, weight gain, muscle loss or gain and the natural ageing process can all cause ligaments and tendons to lose some of their elasticity, changing the arch and foot structure so the foot elongates and widens.
Many of us don’t notice these gradual shifts and go on buying the same size shoes.
The consequences range from blisters, calluses, bunions and hammertoes to excruciating pain and problems with movement.
It will come as no surprise to hear that high heels, sleek and sexy as they are, are no friend to foot health. Most also have narrow silhouettes – which don’t allow for toes to splay properly – and they prop up the heels to sometimes ridiculous heights, whereas your body is designed for the heel to be on the same level as the ball of the foot.
And it’s not just women’s shoes that cause problems. Men’s ‘smart’ shoes typically offer a narrow silhouette too – in fact, it can be hard to find a men’s dress shoe with anything approaching a foot-shaped fit, as very few brands currently offer this.
But you probably will be surprised to hear that excessive cushioning and support – a defining feature of popular ‘maximalist’ running and walking shoes – can also cause problems.
While cushioned shoes can help, in the short term, particularly after an injury, habitual use is another matter.
Heavy cushioning absorbs much of the mechanical impact that would normally travel through the foot, and over time this may contribute to foot deconditioning, muscle weakness, altered gait and poor balance.
Which types of pain can walking ease?
If you’ve injured your wrist or knee, for example, you might be told to follow a familiar protocol known as RICE (short for rest, ice, compression and elevation), first introduced in the 1970s, when it was thought that reducing inflammation by applying ice to an injury was beneficial.
Ice does have an early role to play in immediate pain relief (ie the first six hours) – but after this, its role in reducing inflammation can impede healing.
This is because inflammation is the body’s response to injury, triggering a cellular cascade of response processes that help to heal tissue.
Ice also acts as a vasoconstrictor, tightening blood vessels and slowing the flow of blood to the area. Although this mechanism temporarily helps dampen acute pain, it also shuts down the body’s nutrient highway, which results in key cells and hormones not being delivered to the injury site.
By contrast, gentle, regular walking improves circulation, helps the body to deliver oxygen and nutrients to tissues that are trying to heal and prevents muscles from becoming too weak or stiff – all of which helps in managing pain, promoting healing and reducing overall recovery time.
A 2022 systematic review of research found that walking improved short-term lower back pain and disability scores more than doing no activity. So moving is better than rest.
Cycling and swimming can be helpful too, but the benefit of walking is that everyone knows how to do it and it doesn’t require expensive equipment or training.
But pain isn’t just a mechanical problem or a physical sensation, it also has a psychological component. Emotional stress can make pain feel worse. Someone who has experienced pain can fear it will happen again – or get worse.
The book’s authors, Dr Courtney Conley, left, and Dr Milica McDowell
Understanding this connection between mind and body is essential because depression and anxiety can often accompany chronic pain.
Both emotions can change your brain and your body in ways that ‘turn up the volume’ on pain signals – a process known as hypersensitisation – making pain seem worse. This is because some brain regions, such as the prefrontal and insular cortex, that process physical pain are also involved in regulating mood and emotional responses.
When these areas become very activated, signals can sometimes get scrambled or misinterpreted. This can result in the brain perceiving pain where there is no physical stimulus.
Additionally, chronic pain reduces the levels of ‘feel good’ chemicals such as serotonin and dopamine, making feelings of doom and gloom feel even more prevalent.
Positive thoughts, emotions and relaxation techniques can all reduce the experience of pain. Learning to reframe the way we think about pain and to retrain our brain’s response to it can help reduce its intensity and impact on our lives.
So, which types of pain are best helped by simply heading out of the door in a pair of sensible shoes? In our experience walking forms a vital part of treatment programmes for all kinds of musculoskeletal problems, including lower back, hip and knee and ankle and foot pain.
Lower back
One study involving more than 3,000 people suggested walking could improve chronic lower back pain – and was comparable in the long term with the effects of mind-body activities such as yoga.
Combining walking with ‘lumbar stabilisation’ – exercises to strengthen the muscles around your lower back, including core and abdominal muscles – can also help build strength and prevent chronic lower back pain.
Hip
A 2020 study found that patients who walked on the same day as their hip replacement operation gained better functional improvement than those who stayed in bed – and didn’t suffer greater pain. Walking can also be a valuable part of general pain management techniques for those with hip osteoarthritis – in particular, using hiking or trekking poles.
In one study, involving more than 150 older people with hip osteoarthritis, those who regularly walked with hiking poles reduced their hip pain more than those who did strength training. A year later their hip pain was still reduced.
We often see patients who have been advised to reduce activity and avoid walking until their pain settles down. But lack of movement can also contribute to feelings of depression and anxiety, resulting in even less motivation to move. In turn that can lead to muscle weakness and even greater immobility.
Knee
The key is to modify movement for those in pain, not eliminate it. Where a knee injury is concerned, this might involve taking softer, quicker steps to reduce forces acting on the knee and strengthening other leg muscles to offer more support.
One research-backed tip for chronic knee pain is to walk a bit faster, increasing your pace from 100 steps a minute to 120 a minute – advice that works time and again for our patients, as it eases the forces on the knee joint.
Foot
More than 20 per cent of adults experience foot pain at some point, with women more affected than men. Typically, foot pain is caused by a variety of factors, including injury, overuse, poorly-fitting shoes and imbalanced walking patterns. Matters can be made worse if a person also has other health conditions such as obesity, arthritis or diabetes.
Most people with a foot or ankle injury think the idea of walking is downright ridiculous as it’s a pain you feel with every step.
Nonetheless, gentle exercises to get the joint moving – such as ankle circles – may help, and in many cases of foot and ankle pain, some form of walking should be considered. Barefoot walking can also have strengthening benefits as it allows the foot to move through its natural range of motion, challenging the internal muscles of the foot.
Nerve pain
Whether due to sciatica, a banged elbow or peripheral neuropathy, nerve pain causes a wide range of unpleasant sensations from sharp, shooting sensations, to tingling or even numbness.
Rhythmic movements such as walking can be a powerful way to combat nerve problems, as nerves need blood flow and oxygen to heal: such movement pumps much-needed resources into affected areas.
A 2021 study in Sports Medicine found that progressive aerobic exercise – such as brisk walking – paired with strength training reduced pain and improved the quality of life in people with nerve-related pain such as sciatica.
Getting started
Start small – with a five to ten-minute ‘microwalk’ – and build up from there.
This is low commitment and can easily be done while you are taking a phone call or waiting for a friend.
When you begin, it’s a good idea to set small, realistic goals. For instance, you could start by committing to walking for two days a week – why not arrange for a friend to join you on one?
If you add just 500 steps a day to your baseline step count it’s likely you will reduce your risk of dying from all causes of mortality by 7 per cent
Breaking up your working day with five to ten-minute walking ‘snacks’ is another good way to get your steps in – remember every single step counts.
If you add just 500 steps (five minutes of walking) per day to your baseline step count, and your baseline is more than 2,500 steps, it’s likely you will reduce your risk of dying from all causes of mortality by 7 per cent.
Today globally, the human life span is estimated to be just over 70 years. If you live 7 per cent longer, you might live to be 75. Wouldn’t you like another five years with your loved ones?
Do I need to do 10,000 steps a day?
No! The 10,000 steps mantra is an urban legend that originally stemmed from a marketing campaign by a Japanese pedometer manufacturer, in the 1960s, with no basis in actual research.
Yet it’s persisted for nearly 70 years and has proved discouraging for many people.
The optimum dose of vitamin W is much more achievable: studies show that you can significantly improve your health by walking 3,500 steps (roughly 35 minutes) a day.
Studies show that you can significantly improve your health by walking 3,500 steps a day
Why speed matters
Most of us take 2,000 steps and roughly 20 minutes, to cover about a mile – that’s about 100 steps a minute. A casual stroll is around 100 to 110 a minute, while a brisk walk is nearer 120 to 130 steps a minute.
Upping your walking speed can have a huge impact, partly as it’s easier to adopt less efficient movement patterns when casually strolling, but also because you’ll reap significantly better cardiovascular health benefits from a quicker speed.
Faster walking raises your heart rate, making it more effective for aerobic exercise, and increases momentum, making it much easier to keep going.
A recent Australian study found that people who walked quickly had a 24 per cent reduced risk of death from any cause compared with those who walked slowly.
A major UK study that tracked more than 330,000 adults for more than a decade revealed an astonishing connection between a brisk walking pace and cancer prevention.
People who walked briskly (4mph) had dramatically lower risks for five types of cancer compared with people who walked more slowly – and an average of 55 per cent reduction over all these types.
Researchers now consider gait speed to be an important predictor of some diseases, along with factors such as high blood pressure.
For instance, a slower gait can be detected up to seven years before the clinical onset of dementia, making reduced walking speed an important early marker.
Brisk walking can also help with pain relief, particularly in knee joints. This is because taking quicker, softer steps improves knee loading and gait efficiency, reducing the forces acting through the knees.
This information is intended as general advice only and is not a replacement for consulting your own doctor or health specialist about any injuries or pain.
Adapted from Walk by Courtney Conley & Milica McDowell (Allen Lane, £25), to be published 5th May. © Courtney Conley and Milica McDowell 2026. To order a copy for £22.50 (offer valid to 09/05/26; UK P&P free on orders over £25) go to www.mailshop.co.uk/books or call 020 3176 2937.