Generally, if back pain starts up during a run, it is best to stop running. Continuing to exert the body following these initial symptoms may cause the underlying sprain or strain to worsen. Allowing the back a few days rest to heal is also advisable.

See Treating Acute Sports and Exercise Injuries in the First 24 to 72 Hours

Conversely, some people who experience mild back pain while sitting or resting find that their back pain disappears after a warm up and run. In these cases running is OK, so long as one is taking the precautionary measures to minimize back pain.

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Most of the back pain that runners experience is the result of mild strains or sprains, and typically improve or recede within a few days or weeks. If it seems possible to continue training but the back pain is becoming a detriment, the following self-care measures may be incorporated:

  • Gentle stretching exercises for the upper body, hips, and legs, such as reaching the arms over the head, bending over to touch the toes, or stretching by leaning each side of the body over horizontally while seated on the floor. These exercises can activate the muscle tissue of the back, stimulating blood flow and accelerating the healing process from mild injuries.
  • Using cloth-covered ice or cold packs on the affected area, applied for 10 to 20 minutes at a time, 2 to 3 times per day. The cold from an ice pack can help to reduce inflammation in the back, and reducing inflammation will reduce the pain.
  • Heat therapy, such as applying a warm compress, an electrical heating pad, or a commercial adhesive heat pad to the affected area. Some individuals may find that sitting in a hot tub or sauna for 10 to 20 minutes at a time can also provide relief for a sore or stiff back by relaxing the muscles.
  • Over-the-counter pain medication, such as acetaminophen (Tylenol).
  • Over-the-counter non-steroidal anti-inflammatory medications (NSAIDs), such as ibuprofen (Advil) or naproxen (Aleve), that can provide pain relief as well as reduce inflammation and swelling at the injury site.

Most cases of lower back strain or sprain will self-resolve in a few days to a few weeks. If improvement doesn’t appear over that time, it is advisable to consult a medical professional trained in sports-related injuries.

See The P.R.I.C.E. Protocol Principles


What to Do If Back Pain Lasts More Than a Few Weeks

If running-related lower back pain lasts longer than two to three weeks and/or does not respond to self-care measures, the problem may be more than a soft-tissue sprain or strain. This is especially true for back pain that coincides with “sciatica,” where pain, tingling, numbness, or other neurological symptoms radiate down the one leg - often making running impossible.


Those with chronic back pain should hold off on their training schedule until fully evaluated by a sports physician or therapist. In general, anyone who has had spine surgery is cautioned against going back to running as the impact can be harmful to the spine.

For anyone who has been advised against running, other low impact aerobic conditioning is advisable, such as biking, stationary biking, or spin classes, elliptical training, swimming or water therapy. Walking on a treadmill is also a good option, as the treadmill has some cushioning to lessen the impact on the spine.

A doctor trained in sports medicine or spine care can determine the underlying cause of the back pain, and develop an accurate prognosis and treatment plan.

Dr. Isador Lieberman is an orthopedic surgeon at the Texas Back Institute. He has been performing spine surgery for more than 25 years. He has served as Professor of Surgery at the Cleveland Clinic Lerner College of Medicine and as Medical Director of the Scoliosis & Spine Tumor Program at Texas Health Resource Hospital.