Manage Longstanding Low Back Pain by Spending Time in Nature

Study Overview

The article “Being away from everything”: Exploring the importance of access to nature for individuals living with chronic low back pain, published in the Journal of Pain, investigates how nature can aid in managing chronic low back pain (cLBP). It involved ten semi-structured interviews with people averaging 50.1 years old and living with cLBP for about 19.1 years.

Key Findings

The study found that nature can provide distraction, reduce isolation, and offer a calming environment, enhancing pain self-management. However, many face challenges like physical disabilities, environmental hazards, or lack of proximity to natural spaces. It suggests integrating nature-based activities into treatment plans and exploring virtual reality for those unable to access nature.

Detailed Analysis and Background

The article presents a pioneering qualitative cross-sectional study focused on understanding the role of natural environments in managing chronic low back pain (cLBP). The study, conducted and published in June 2025, addresses the growing evidence against the effectiveness of ‘one-size-fits-all’ pharmacological approaches, advocating for alternative non-pharmacological therapies such as green social prescribing and spending time in nature.

Methodology and Participants

The research methodology involved ten semi-structured interviews, primarily with women (9 out of 10 participants), with an average age of 50.1 years and an average duration of living with cLBP of 19.1 years. This qualitative approach aimed to explore the lived experiences of individuals, providing deep insights into their coping strategies and the role of nature in ameliorating pain. The analysis was conducted using Reflexive Thematic Analysis, identifying two main themes: (1) Importance of Nature and (2) Inaccessible Nature, each with four subthemes respectively.

Key Findings and Themes

The theme “Importance of Nature” underscores the benefits of accessing natural environments, which can significantly aid in self-management of cLBP. Participants reported that being in nature offered distraction, reduced feelings of isolation, and provided a calming environment, which helped alleviate pain and improve mental well-being. For instance, those able to immerse themselves in larger green spaces, such as forests, felt more positive, as they could lose themselves in the environment and focus less on their pain levels.

However, the theme “Inaccessible Nature” revealed significant barriers, including physical disabilities, environmental obstacles or hazards, and geographical limitations. These challenges often undermined the ability to access nature, highlighting an unmet clinical need. The study emphasizes that many individuals encounter substantial obstacles, such as uneven terrain, limited seating, or difficulties leaving their homes, making it challenging to benefit from the restorative properties of nature.

Implications and Recommendations

The findings suggest that integrating nature-based activities into treatment plans could be beneficial, offering a promising avenue for improving overall well-being for those with cLBP. The researchers recommend exploring virtual reality interventions to simulate nature experiences for those unable to access outdoor spaces, addressing accessibility issues. This approach could help make the benefits of nature accessible to everyone, potentially through technological innovations. Simple changes, such as better paths and seating, were also suggested to enhance real-world access.

The study marks the first qualitative investigation focusing directly on the nuanced role of natural settings within the coping mechanisms employed by people with cLBP. This pioneering aspect underscores the need for further research into how nature can be incorporated into holistic and multidisciplinary frameworks for treating pain, aligning with leading international organizations’ recommendations.

Contextual Background

Chronic low back pain is a major public health issue, with the highest prevalence globally among musculoskeletal conditions and being the leading cause of disability worldwide. It affects individuals of all ages, with peak cases at 50–55 years, and women experiencing it more frequently. The condition often leads to work loss, participation restriction, and reduced quality of life, making innovative approaches like nature-based interventions particularly relevant.

The study’s emphasis on accessibility challenges also aligns with broader discussions on health equity, addressing significant physical barriers faced by people living with chronic pain, as highlighted in the University of Plymouth news release. This includes the need for better infrastructure, such as improved paths and seating, to facilitate access to natural spaces.

Conclusion

In conclusion, the article provides valuable insights into the therapeutic potential of nature for individuals with cLBP, while also highlighting significant accessibility barriers. It advocates for innovative solutions like virtual reality to bridge these gaps, contributing to the broader discourse on holistic pain management. The findings are particularly timely, given the current understanding of cLBP as a major global health challenge, and offer a foundation for future research into nature-based interventions.