Wittchen, PJ ORCID: https://orcid.org/0009-0002-8861-1430, Vincent, Grace E ORCID: https://orcid.org/0000-0002-7036-7823, Samanna, Claire L ORCID: https://orcid.org/0000-0001-5035-7006, Neason, Christopher ORCID: https://orcid.org/0000-0002-7937-7737, Belavy, Daniel L ORCID: https://orcid.org/0000-0002-9307-832X, Clarkson, Matthew J ORCID: https://orcid.org/0000-0003-0447-9269, Mitchell, Ulrike H ORCID: https://orcid.org/0000-0002-2298-8756, Mundell, Niamh L ORCID: https://orcid.org/0000-0001-5406-3216, Tagliaferri, Scott D ORCID: https://orcid.org/0000-0003-3669-4131 and Owen, Patrick J ORCID: https://orcid.org/0000-0003-3924-9375 (2026) Running improves mental health symptoms and pain catastrophising in adults with chronic low back pain: a secondary analysis of the ASTEROID randomised controlled trial. Journal of Science and Medicine in Sport, 29 (1). pp. 79-84. ISSN 1440-2440

Abstract

Objectives: This pre-planned secondary analysis examined the effects of a running intervention on mental health symptoms and pain catastrophising in adults with chronic low back pain. Design: Two-arm parallel individual randomised (1:1) controlled trial. Methods: This study randomised 40 adults (mean [standard deviation] age: 33 [6] years, female: 50 %) with non-specific chronic low back pain to a 12-week running (progressive run–walk interval exercise training) intervention (n = 20) or waitlist control (n = 20). Outcomes were mental health symptoms (21-item Depression, Anxiety, and Stress Scale) and pain catastrophising (Pain Catastrophising Scale). Data were collected at baseline, six, and 12 weeks post-baseline. Separate linear mixed models with random effects (participants) evaluated within- and between-group changes. Results: At 12 weeks post-baseline, running improved overall mental health symptoms (estimated marginal mean net difference [95 % confidence interval] points: − 4.35 [− 7.73, − 0.97], P = 0.012), depression symptoms (− 1.75 [− 3.42, − 0.08], P = 0.040), stress symptoms (− 1.65 [− 3.01, − 0.29], P = 0.017), and pain catastrophising (− 7.85 [− 11.98, − 3.72], P < 0.001), yet not anxiety symptoms (− 0.95 [− 2.16, 0.26], P = 0.122), compared with control. Conclusions: Running improved mental health symptoms and pain catastrophising among adults with non-specific chronic low back pain when compared to waitlist control. Differences in pain catastrophising, yet not mental health symptoms, were clinically meaningful. Running appears to be an efficacious treatment for psychological comorbidities common among adults with non-specific chronic low back pain.

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