Running puts a high level of repetitive stress on the back, and for those with lower back problems it is particularly important to take measures to reduce the strain on the lower back.

In general, the following tips are advisable for runners, especially for those who are susceptible to low back pain or leg pain/sciatica:

  • Do a thorough warm-up prior to beginning a run
  • Stretch the hamstrings (the large muscles in the back of the thigh) twice daily to minimize stress across the low back
  • Muscle toning and strength training are also important, particularly with the core muscles of the back
  • Cross training is useful, so as not to get into an overuse syndrome
  • Wear comfortable, supportive shoes
  • Try to run on a forgiving surface if possible, such as a rubber track, and try to avoid running on cement

It is important that back pain patients take note of any back symptoms that perhaps are being exacerbated by a particular activity. If running consistently brings on back pain or leg pain symptoms, an evaluation with a spine specialist, including X-rays and perhaps an MRI, can be useful to determine the source of that pain.

Again, muscular sprains and strains tend to be short-lived and respond well to self-care measures, such as heat, stretching, and an anti-inflammatory medication (e.g. Motrin or Advil). If the pain does not respond to these measures, there may be a more structural problem that requires medical treatment.

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More structural problems such as disc herniations, degenerative disc disease and spondylolisthesis may require a more thorough evaluation and treatment by a spine specialist.

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  • When the symptoms of the condition are not too severe, an integrated treatment approach, such as a combination of physical therapy, pain medications, injections, and/or bracing, is often effective in managing the pain.
  • When there is a more significant neurological impingement (often indicated by severe or progressive leg pain, sciatica and/or leg weakness and numbness, or foot drop) or more severe symptoms, spinal surgery may become advisable.

With all of the treatment approaches, the goals are to get the runner back to a healthy state where he or she can continue to enjoy exercise with minimal or no pain.

For more in-depth information, see Common Running Injuries: Back Pain on Sports-health.com.

Dr. Sean McCance is an orthopedic surgeon in New York City and has been practicing spine surgery for more than 20 years. He serves as Co-Director of Spine Surgery at the Mount Sinai Hospital and Director of Spine Associates, a private practice where he specializes in complex reconstructive spine surgery.

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