Lower Back Pain When Running: Causes & Prevention

An estimated 50 million people participated in running or jogging at least once in the year 2023. Reasons for its popularity include the availability of suitable running environments, the low cost of participation, and the quality of the exercise for those who participate. Even if the weather does not permit outdoor running, it’s not hard to find an inexpensive gym with a treadmill or to purchase a treadmill for your home.

Given the popularity of running, it makes sense that it would be the cause of many musculoskeletal injuries, especially lower back pain when running. In this article, we’re going to discuss the causes of lower back pain from running, some treatment options, ways it can be prevented, and some frequently asked questions.

Common causes of lower back pain while running

Many things may cause lower back pain when running. Some are sourced internally in your body, some have to do with technique, and others have to do with the environment in which you run. Common causes of lower back pain when running are listed below.

Muscle strain

One of the main causes of lower back pain while running is muscular strain, which occurs when the muscles are stretched too far, leading to a tearing of the muscle fibers. Muscle strains are common and can be quite painful. It’s important to know when your muscle strain requires medical intervention.

Poor running posture

Lower back pain while running may be caused by poor running form. Your stance should be vertical, not hunched over. Keep your shoulders relaxed and your head in line with your shoulders and trunk. Keep your arms by your side with a 90-degree bend in the elbow, and do not swing them too much. Your feet should land beneath your hips and not way out in front of your body.

Weak core

The core is the centralized musculoskeletal area of the body that consists of the abdominal muscles, lower back, hips, and pelvis. One main area that can be improved in preventing lower back pain while running involves strengthening the core muscles.

Tight muscles

Tight muscles can lead to muscle strain of the lower back and cause lower back pain while running. Some examples of tight muscles that frequently lead to muscle strain include the hamstrings, hip flexors, and calves.

Running on an uneven surface

If you run on a road that has potholes or is otherwise uneven, it can lead to lower back pain from muscle strain. This is one of the most common causes of lower back pain among runners.

Wearing poor running shoes

Wearing quality sneakers is important. If your running shoes are not of good quality, it can affect your posture, stride, and muscles. In addition, if your sneakers are worn out, it can lead to muscle strain since most runners wear out their sneakers in specific patterns according to their physiology.

Disc disease

If you have disc disease in your lower back, it can be made worse by running. The disc can then become herniated and move out of place, pressing on the nerve root or spinal cord and causing lower back pain.

Arthritis

There are different types of arthritis, including rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, diffuse idiopathic skeletal hyperostosis (DISH), psoriatic arthritis, and gout. Any of these conditions can be made worse with the movement of running and the force of continuous landing on the pavement.

How to treat lower back pain when running

There are many ways to treat lower back pain from running, and most can be accomplished at home. With the following techniques, there is a good chance you will be able to alleviate your symptoms fairly quickly.

Over-the-counter medications

Over-the-counter medications are an immediate way to treat lower back pain from running. Aspirin is a good first choice. If it does not relieve your pain, you can use ibuprofen (Advil, Motrin) or naproxen (Aleve) to see if that helps.

The above three medications are in the class called non-steroidal anti-inflammatory drugs (NSAIDs). Some people have gastrointestinal (GI) issues from NSAIDs, like ulcers and irritable bowel. For those people, we recommend acetaminophen (Tylenol), which is not known to cause any ulcers or GI issues.

Ice or heat

The traditional theory for a muscle strain was to use ice for 24 hours after the injury or when pain begins and then use heat afterward. Ice is still recommended for the first 24 hours, but you can continue to use ice after that time if you find it helpful. For ice therapy, there are reusable ice packs available for purchase, while electric moist heat packs can work well to supply heat therapy.

Professional massage

Professional massages can be a great way to obtain immediate relief for lower back pain when running. It can also be very helpful in the long term to prevent further injury.

How to prevent lower back pain when running

There are several ways to prevent lower back pain when running, including medications, stretching before and after running, improving core strength, and wearing quality running shoes.

Medications

Taking over-the-counter medications before going for your run or jog can prevent lower back pain from occurring in the first place. However, this should only be done on an occasional basis, given the side effects and possible toxicity of the medications.

Stretching

Stretching before and after you run is a great way to prevent lower back pain. Stretching after your run will help to avoid pain during your next run. Before your run, the muscles are cold, so do not stretch too strenuously. Once you start running, the increased blood flow to your muscles will loosen them naturally.

Core strength

Having strong abdominal muscles will help you prevent the development of lower back pain when running. There are numerous abdominal exercises available to assist you in strengthening your core muscles.

Wear good running shoes

If you run frequently, try to get a new pair of sneakers every few months. Running sneakers may wear down quickly, so it’s important to recognize when it’s time to replace them.

When to see a doctor about lower back pain when running

Developing low back soreness after running can be normal depending on your age, length of the run, and environmental conditions. However, the discomfort should go away with simple treatments like stretching, ice, or heat. If the symptoms continue over time, then you should seek medical care for diagnostic testing and treatment.

You should see a doctor if:

• You get pain each time you go running that does not resolve with stretching, ice, or heat.
• You have to stop in the middle of your run due to lower back pain.
• You develop frequent numbness or tingling in your legs while you run.
• Your lower back goes into spasm after your run, not allowing you to sit down or stand up straight.
• You cannot walk normally after your run.

You should go to the emergency room (ER) if:

• You get sharp shooting pain down the back of your leg.
• You develop extreme weakness in the legs.
• If there is any loss of bowel or bladder control.

Frequently asked questions: lower back pain when running

You may still have some questions about lower back pain when running. Below are some frequently asked questions you may find helpful.

What if you only feel lower back pain during or after running on a treadmill?

The issue of lower back pain when running on a treadmill as opposed to outdoors has to do with the lack of variation of speed and incline on the treadmill, which leads to the overuse of certain low back muscles, tendons, and ligaments. Since you’re not engaging in different or varied running patterns like you would be if you were running outdoors, this can lead to overuse injuries. When you continuously use the same muscles, tendons, and ligaments, they become worn and sore.

What if you only feel lower back pain after running uphill?

When running uphill, you lean forward, and your neck moves forward. This can place a larger strain on certain muscle groups, tendons, and ligaments of the lower back that are different from the ones used for flat running. This can cause pain that is only felt when running uphill.

Managing lower back pain when running

You may be one of the 50 million Americans out there who love a good jog or run outdoors on a really nice day – or on a treadmill on a not-so-nice day. But lower back pain can develop during or after this activity and place a damper on your experience.

However, knowing the causes, treatments, prevention methods, and red flags can help you manage lower back pain from running. As a result, running can once again become your favorite method of exercise.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Lane Thaut, DO.

Sources

Maselli, Filippo, et al. “Prevalence and Incidence of Low Back Pain among Runners: A Systematic Review.” BMC Musculoskeletal Disorders, vol. 21, no. 1, June 2020, p. 343. BioMed Central, https://doi.org/10.1186/s12891-020-03357-4.

Wu, Bao, et al. “Incidence and Risk Factors of Low Back Pain in Marathon Runners.” Pain Research & Management, vol. 2021, Feb. 2021, p. 6660304. pmc.ncbi.nlm.nih.gov, https://doi.org/10.1155/2021/6660304.