How to Start a Walking Program For Chronic Pain

physical exercise as non pharmacological treatment of chronic pain
Terri Night
Written by
Terri Night Physical Therapy

Walking is the simplest form of aerobic exercise, but it can be intimidating when you’re starting from scratch. I’ve outlined a simple test for identifying your level of walking ability. This can help you develop a walking program that works for you. It’s also a great way to track your progress. And a great way to exercise your chronic pain away.

STEP ONEPerform a Walking Self-Assessment

Figure out your Pre-Symptomatic Walking Time (PSWT) or Distance (PSWD). This is the amount of time (or distance) you can walk before you start to have symptoms.

How to do it?

  • Time how long you can walk on level ground before you experience:
    • Discomfort, cramping, numbness, or weakness in the legs
    • A need to hunch over (more than when you started)
    • Any other symptoms (such as pain or aching)
  • Measure the distance walked before these symptoms kick in.
    • You can be really specific (with a pedometer) or use a rough estimate (“I can walk to the mailbox and back.”)
  • Write it down and track it. If it’s helpful, use the attached chart.

STEP TWO – Start Adding Variables to See If You Can Increase the Time on Your Feet

See if your PSWT or PSWD increases with the use of: 

  • A cane
  • Trekking poles
  • A four-wheeled walker with seat
  • A treadmill
  • A front-wheeled walker
  • A lumbar corset

If your walking tolerance increases with one of the above, consider using it for your walking program. You don’t have to try each and every one of them, but the more you experiment, the more information you’ll have, and the better you’ll be able to identify what works best for you.

STEP THREE – Identify Your Category and Strategy 

See which of these categories is the best fit for you:


  • In order to get 150 minutes per week of aerobic exercise, you’ll need to focus on alternatives to walking (exercise bicycle, pedaler, or Nu-step) while supplementing with some type of assisted walking (walker, 4-wheel walker, or trekking poles).
  • A good walking program strategy would be to shuttle walk* a comfortable distance for you, with a 30-second seated rest in between. Continue to shuttle walk for 10–30 minutes or until your ability to walk half the distance of your PSWD becomes difficult.
  • Some of us begin at Bronze Bullet and stay there. This is perfectly respectable. This isn’t a race or competition; this is about feeling the best you can feel


  • Able to walk between 500 and 999 feet or between 5 and 15 minutes.
  • To reach your goal of 150 minutes per week, you can walk 10–15 minutes twice daily for five days per week. You may want to supplement this with longer sessions of an alternate type of exercise, like water aerobics or an exercise bicycle. You can also extend your walking time using trekking poles or a treadmill.


  • Able to walk more than 1000 feet and more than 15 minutes.
  • You can probably use walking as your primary aerobic exercise and still achieve your 150 minute per week goal. You might incorporate trekking poles into longer walks, use a treadmill, or use another type of alternative exercise to get your heart rate up a little higher, or to just get some variety.
What walking category do you associate with most?
Walking Categories

STEP FOUR OK, now what?

Now that you’ve found your category, use the strategy associated with it to see if you can:

  • Improve your pre-symptomatic walking time (PSWT) or distance (PSWD).
  • Meet the criteria of 150 minutes per week of moderate aerobic exercise.
  • Make yourself feel better gradually over time.

Your Exercise plan chronic pain is on its way to a fruitful start. Stick to it and believe in your capacity to change.


For overall cardiac health, The American Heart Association recommends a goal of at least 150 minutes (i.e. two-and-a-half hours) per week of some kind of moderate aerobic exercise. Assistive devices allow you to unload the spine. This lets you stay on your feet a bit longer. Shuttle walking can be used by both short and long-distance walkers as an exercise for chronic pain.

Walking is not the only way you can get aerobic exercise. A combination of many different types of aerobic exercise provides optimal results. Always consult a trained healthcare professional before beginning any new exercise program. 

Terri Night
Written by
Terri Night Physical Therapy

Terri Night, PT is the author of Rehab Your Own Spinal Stenosis: strategies to improve the health of your spine. As a licensed physical therapist specializing in back pain, back surgery rehab, and chronic pain management, her presentations have been featured at Physician Grand Rounds for Alta Bates and Summit hospitals, as well as several Bay Area senior centers and health expos. For more information visit

This article is for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice from your physician or health provider for your specific needs.

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