The repetitive impact of running can cause back pain, most commonly low back pain. Whether this pain is caused by strained muscles or by a problem with the spine's vertebrae or discs may influence treatment and training.

Injury to Back Muscles and Ligaments

Back muscles and ligaments keep the spine upright and help maintain good posture during a run. A runner may experience the following symptoms if these soft tissues become fatigued and strained:

The back may feel dull and achy
The affected area may be sore to the touch
Flexibility may decrease, so that bending over or twisting at the waist is difficult and uncomfortable

Occasionally, pulled back muscles will spasm, causing severe pain that prevents daily activities. In these cases, it is possible for the muscle to squeeze a nerve root and cause radiating pain to the arms or legs, known as radiculopathy or sciatica.

While strained back muscles and ligaments are painful and can be temporarily debilitating, they are relatively benign. When provided adequate rest and treatment, pain should be gone within 2 to 4 weeks.

Injury to the Spine

Injury to the spine is among the top 10 running injuries. ¹ Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002 Apr;36(2):95-101. PubMed PMID: 11916889; PubMed Central PMCID: PMC1724490. Both the spine's vertebrae and intervertebral discs experience extra pressure each time a runner's foot impacts ground. This pounding can exacerbate an existing or developing back problem.

Examples of these problems include herniated discs, degenerative disc disease, and vertebral stress fractures.

Herniated disc
The vertebral discs act as shock absorbers between the spine's vertebrae. When a vertebral disc is squeezed out of its normal space it is called a herniated, bulging or ruptured disc. If a herniated disc pushes against a nearby nerve root or against the spinal cord it can cause significant pain. The most common area for herniated discs is the low back, particularly between the L4-5 vertebrae.

Learn more about Herniated discs on Spine-health.com

Degenerated disc
Disc degeneration disease is not actually a disease but the gradual breakdown of one or more intervertebral discs. Over time, a disc's firm outer layer undergoes wear-and-tear and can weaken. Additionally, a disc's gelatinous core can lose water content, so the disc is flatter, offers less cushion, and is less flexible. Disc degeneration begins as early as childhood, and by age 60 most people will have some degree of disc degeneration, though not everyone will experience pain.

Learn more about Degenerative Disc Disease on Spine-health.com

Vertebral fracture (Compression fracture)
Typically, healthy vertebrae only break after a serious physical trauma, such as a severe car accident. However, a vertebra that is weakened by osteoporosis, prolonged corticosteroid therapy, infection, ankylosing spondylitis, or certain other diseases can experience a stress fracture. Pain may develop gradually and be more noticeable when standing up. Treatment usually does not require surgery.

Learn more about Vertebral fractures on Spine-health.com

Among runners, women with a lower than average body-mass index are at the highest risk for spinal injury. ¹ Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002 Apr;36(2):95-101. PubMed PMID: 11916889; PubMed Central PMCID: PMC1724490.

How much pain a person experiences depends on the nature of the back injury and the individual runner. A person who consistently gets nagging lower back pain after runs or has pain that radiates to the buttocks or legs should seek a medical evaluation.

As a general rule, running injuries should be treated early on. Runners who try to "run through the pain" may cause their injuries to get worse.

Watch Dynamic Warm-Up for Running with Low Back Pain Video on Spine-health.com

Dr. Andrew Cole has 30 years of experience specializing in spine and joint pain management. Dr. Cole has held numerous medical appointments throughout his career, and recently served as the Executive Director of Rehabilitation & Performance Medicine Enterprise for Swedish Health Services and as Medical Director of Ambulatory Musculoskeletal Services for Swedish Medical Group.

1 Taunton JE, Ryan MB, Clement DB, McKenzie DC, Lloyd-Smith DR, Zumbo BD. A retrospective case-control analysis of 2002 running injuries. Br J Sports Med. 2002 Apr;36(2):95-101. PubMed PMID: 11916889; PubMed Central PMCID: PMC1724490.