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Lower back pain when running? Why it happens and how to fix it

Learn why your back hurts when you run and if you can continue running.
Maryke Louw
Maryke Louw
Jan 22, 2024
Medically reviewed by
Kim Van Deventer
This article explains why your back hurts when you run, how to know if you can continue running, and how to adjust your runs to help recovery.

Why does my back hurt when I run?

Some of the main reasons why your back may hurt during or after a run include the following:

  1. Overly stiff or tight back - Caused by sitting for long periods or doing lots of exercise and no mobility work.
  2. Decreased strength in your core (stomach, back, and hip muscles) - Makes it easier to strain or irritate your back.
  3. Increasing your training intensity too quickly - Doesn't allow enough time for your back to strengthen, increasing your injury risk.
  4. Not allowing enough recovery time after runs - Doesn't allow your body the time it needs to rebuild and repair, predisposing you to overuse injuries. Other factors influencing recovery, like sleep or nutrition, may also play a role.
  5. A back injury unrelated to running - When injured, your back usually loses some strength and endurance and irritates easily. You may have to restore its strength before it can cope with the loads from running.
  6. Stress and anxiety - Cause the release of stress hormones (like cortisol), which can cause or increase pain.

The Back Pain rehab plan in the Exakt Health app helps you build strength while restoring your back's mobility. The app is tailored specifically for runners and includes a prevention (prehab) plan to help you remain injury-free after recovering.

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Back pain Rehab & Prehab plans for Runners!
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Female runner using the back pain rehab plan in the Exakt Health app to rehab her back injury.

Can I run with lower back pain?

Yes, in some cases, you may be able to run with lower back pain, but you may have to adjust how and where you run.

Some back injuries do, however, require you to stop running for a while. These include:

  • Sciatica or nerve root compression
  • Spinal cord compression
  • Disc injuries
  • Bone stress injuries, including stress fractures
  • Fractures
  • Severe back sprains

A physical therapist can help you understand when you're ready to safely return to running if you have one of these back injuries.

If your back pain doesn't fall into any of these categories, you may be able to continue running. Let's look at how you can decide if it's OK to continue.

You can often continue running while recovering from back pain by adjusting your training plan or technique.
You can often continue running while recovering from back pain by adjusting your training plan or technique.

How to decide if running is OK for your back

These are the steps a physical therapist would use to help you decide if you should stop, adjust, or continue running as usual:

  1. Observe how your back pain reacts during and in the 24 hours after a run
  2. If it is giving you signs that running is not good for it at the moment (see below), check if adjusting your speed, distance, frequency, terrain, etc., helps
  3. If running continues to irritate your back despite making adjustments, then it may be best to stop running for a while and focus on your rehab
  4. If you find that running does not affect your pain or that you can run pain-free by adjusting what you do, then it is likely OK to continue running within those parameters

❌Signs that running may not be good at the moment

  • Your back is quite painful when walking
  • When you try to run, your pain increases significantly (by more than 3/10)
  • Your back feels OK while running, but it is a lot more painful several hours after a run, and it remains more sensitive and sore the next day

✅Signs that it may be OK to continue running

  • Your pain does not increase significantly during a run - you may be a little more aware of your back pain, but it stays within your normal pain levels (what you feel even when not running) or gets better during the run
  • Once you stop running, any extra discomfort you felt during the run calms down within a few hours
  • There is no increase in your pain or discomfort the day after a run
Adjusting your running form may help reduce your back pain.
Adjusting your running form may help reduce your back pain.

How to adjust your running to help your back recover

An injured back generally cannot tolerate as much load or work as before it got injured.

To allow it to recover, it can help to temporarily reduce the work it has to do when you run to a level it can comfortably cope with.

Try to answer the question: How can I adapt my runs so they don't irritate my back?

Everyone is different, so it may take some trial and error to figure out your optimal plan.

How to adjust your running

Some things that may be worth testing include the following...
1
Speed
Sometimes, shorter, faster runs work better because they force you to have better form. Other times, reducing your pace significantly and only doing really easy and slow running is better.
2
Distance
Back pain usually responds better to shorter runs. Long runs are more likely to exhaust you and push your back beyond its current capacity - you may think 5 miles is short, but if that hurts your back, test something significantly shorter (e.g., 2 miles).
3
Terrain
Running uphill or on steep inclines is often more painful than running on the flat. Some runners with back pain report being more comfortable running on soft surfaces like grass or treadmills.
4
Frequency
Sometimes your back simply needs more recovery time between sessions. Test if it helps to reduce the number of runs you do per week and leave at least one or two recovery days between them.
5
Running style
Taking very large strides and landing with your heel far out in front of you (known as overstriding) can increase the force through your back. An easy fix is concentrating on taking shorter, softer strides and focusing on landing with your foot more underneath you.

We've previously discussed how to assess and correct your running form.

Don't forget to treat the cause!

Being injured sucks. But it can turn into a more positive experience if you can learn from it and take steps to avoid making the same mistakes in the future.

Often, several factors combine to cause back pain. Look back at the causes listed at the start of this article. Think about when and how yours started - do any of those causes apply?

The best way to prevent back pain from recurring is to change your habits or take steps to avoid training mistakes that may have caused your current episode.
The best way to prevent back pain from recurring is to change your habits or take steps to avoid training mistakes that may have caused your current episode.

If you feel that sitting at your desk was part of the problem, this article may help.

Did your training plan lack regular strength and mobility training? In that case, the workouts in the Exakt Health app can help. The app offers personalized guidance and evidence-based tips for smoothly and effectively managing and preventing injuries in runners.

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Male runner using the back pain rehab plan in the Exakt Health app to rehab her back injury.
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Maryke Louw
Maryke Louw
Maryke Louw is the Medical Lead at Exakt Health and a chartered physiotherapist. She has a BSc in Physiotherapy and an MSc in Sports Injury Management and has been working with athletes of all abilities and ages for more than 20 years. Maryke combines her extensive knowledge of sports injury treatment with the latest research to provide effective injury treatment and prevention advice.
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