Throughout the last three decades the management of LBP has changed radically from primarily passive treatments and bed rest to patient centred active treatments involving exercise, resulting in improved outcomes with regards to pain, daily function, and return to work [3-5]. As a result of this development, a wide variety of specific exercise regimes have emerged, however, there is little evidence that one type of exercise is superior to another in the treatment of LBP, even though sub-groups of patients benefiting from specific exercise interventions have been identified [5]. Based on results from a recent randomized clinical trial Hurwitz et al. went as far as to suggesting that maybe LBP patients should refrain from back specific exercises and instead focus on non-specific physical activities in order to reduce pain and improve health [6], thereby adding LBP to the already long list of health conditions that are influenced positively by physical activity.

Nordic Walking (NW) is a fast growing and popular way to exercise in northern Europe, in particular in Scandinavia and Germany [7]. NW is low-tech and cheap; it doesn't require a lot of skill and can be done by almost anybody. NW is performed by walking using poles with rubber or spike tips in the same way as in Nordic style skiing. By using the poles the muscles in the upper body are activated and the length of each step taken is increased resulting in a faster gait. Consequently, NW appears to increase cardiovascular metabolism even in healthy people [8,9]. So far the effect of NW on pain and disability in relation to LBP has not been investigated however if shown effective, NW would constitute an attractive low-tech, low-risk, and low-cost intervention. Furthermore, it is not known whether LBP patients are willing to comply with the prescribed dose and frequency, a problem commonly encountered in other forms of exercise therapy for LBP [10], and whether compliance plays a role in relation to pain and disability outcomes.