Being in nature can help people with chronic back pain manage their condition

The research, published in The Journal of Pain, is the first of its kind to ask people experiencing chronic lower back pain – in some cases for almost 40 years – about the role nature plays in any coping strategies they employ to help manage their condition.

The researchers found that people able to get out in nature said it enabled them to connect with others on a social level whereas they might otherwise spend the majority of their time indoors and isolated.

It provided them with a degree of distraction from their pain and a sense of escapism from their daily lives, and they enjoyed the opportunity to exercise in pleasant surroundings, preferring it to gyms or similar settings.

In addition, natural features such as fresh air and the sound and visual presence of water, the interviewees said, helped give them a feeling of tranquillity that relieved the stresses and anxieties created by their pain levels.

However, they did have concerns about the accessibility of some spaces, with factors such as unsteady or uneven terrain and a lack of seating having the potential to reduce their enjoyment of – and making them less inclined to visit – certain places.

Based on their findings, the researchers have recommended that people with chronic lower back pain – and the clinicians treating them – give greater consideration to the role nature can play in their health and wellbeing, and suggested natural spaces could be adapted to incorporate more accessible design features.

They are also working with people with varying forms of chronic pain to develop and test virtual reality innovations that may enable them to experience the benefits of being in nature on occasions where they can’t physically access them.

The study was conducted by experts in pain management and environmental psychology at the University of Plymouth and University of Exeter, and is based on interviews with 10 people who had experienced chronic lower back pain for between five and 38 years.

Alexander Smith, a PhD researcher in the University of Plymouth’s School of Psychology and the study’s lead author, said: “Lower back pain, like many other forms of physical discomfort, can be debilitating, isolating and exhausting. But amid a push for novel and more holistic therapies to treat chronic pain, nature has been suggested as a potential option. Our research showed that those able to get out into nature saw the benefits of doing so, both from a physical and a mental perspective. Simple changes, such as better paths and seating, and technological innovations including virtual reality may help make those benefits accessible to everyone. But we hope our findings open the door to greater exploration of how that might be achieved.”

Dr Sam Hughes, Senior Lecturer in Pain Neuroscience at the University of Exeter and the study’s senior author, added: “This study addresses important questions about health equity and the significant physical barriers faced by people living with chronic pain in accessing natural spaces. Many individuals encounter substantial obstacles, including uneven terrain, limited seating, or difficulties leaving their homes, making it challenging for them to benefit from the restorative properties of nature. We think that future research could use immersive technologies, such as virtual reality, to help overcome these barriers which would enable individuals to experience the benefits of nature without needing to physically navigate inaccessible environments. This could significantly enhance inclusivity and accessibility in chronic pain management strategies in the future.”