Effectiveness and acceptability of a swimming program for low back pain
Anita_Pattison
Fri, 11/06/2026 – 12:31
Grant recipient: Deborah Wareham
Project title: Effectiveness and acceptability of a swimming program for low back pain: a randomised controlled trial
Year awarded: 2024
Grant: Seeding Grant
Grant amount: $11,936
Snapshot: Chronic low back pain is the leading cause of disability worldwide and a major contributor to healthcare costs and lost productivity. Exercise and education are recommended as first-line treatments. Swimming is commonly recommended in clinical practice, but there is limited evidence to supporting its recommendation.
To address this evidence gap, Deborah Wareham and colleagues conducted the first randomised controlled trial to specifically investigate the effectiveness and acceptability of a physiotherapist-guided swimming program for people with chronic non-specific low back pain. The EduSwim trial recruited 76 adults from across Australia and compared an eight-week individualised swimming and education program with education alone. Participants in the swimming group received an individualised swimming program and support through telehealth consultations with a physiotherapist, while both groups received evidence-based education about low back pain.
The findings: The study found that participants who completed the swimming and education program experienced greater improvements in disability at eight weeks compared with participants who received education alone. Improvements in pain intensity were also observed, although these benefits were smaller and may not have been clinically significant. Across a range of secondary outcomes, including function, confidence and self-efficacy, participants in the swimming group generally achieved better outcomes in the short term.
Importantly, the findings showed that swimming can be an effective exercise option for people with chronic low back pain. Participants reported that swimming appealed to them because it was low impact, reduced strain on the body and enabled them to exercise with greater confidence. Many also reported broader benefits, including improved wellbeing and increased confidence to manage their condition.
While improvements were evident at the end of the eight-week program, the differences between groups reduced over time. The study found that maintaining long-term participation in swimming could be challenging, with some participants reporting barriers related to time, access to pools and other practical considerations.
Adverse events were more common among participants in the swimming group than the education-only group, although almost all were non-serious. One cardiovascular event occurred during the trial but was considered unlikely to be related to the intervention.
Benefits to the profession: This study provides the first high-quality clinical trial evidence supporting swimming as a treatment option for people with chronic non-specific low back pain. The findings help address a longstanding evidence gap, as swimming has frequently been recommended by clinicians despite limited research evaluating its effectiveness.For physiotherapists, the results expand the range of evidence-based exercise options available for managing chronic low back pain. The findings suggest that an individualised swimming program, supported by physiotherapy guidance and education, can improve disability and help people engage in meaningful physical activity.
The research also highlights the importance of tailoring exercise recommendations to individual preferences, abilities and circumstances. While swimming may be an effective option for some people, physiotherapists should consider factors such as access to facilities, confidence in the water and strategies to support long-term adherence.
Importantly, the study demonstrates the role physiotherapists can play in supporting behaviour change through personalised exercise prescription, education and health coaching principles. The findings provide clinicians with evidence to better discuss the potential benefits and risks of swimming with people living with chronic low back pain and support informed, patient-centred decision-making.
Read about the findings of Deborah’s study and learn more about her article in The Conversation and InMotion.
Seeding Grant
$11,936
Back Pain
Deborah Wareham
Add Comment