Better health begins with a pain specialist.

Lower Back Pain During Running: Causes, Management, and When to See a Specialist

Lower back pain can be a frustrating barrier for runners, ranging from mild discomfort to severe agony that hampers performance and affects daily life. Understanding the root causes, effective management strategies, and knowing when to consult a pain specialist can help runners maintain their stride pain-free.

What Causes Lower Back Pain During Running?

Several factors contribute to lower back pain in runners, stemming from both intrinsic and extrinsic sources. One common cause is poor running form. Slouching or leaning too far forward can place undue stress on the lower back muscles and spinal column. Overpronation, or excessive inward rolling of the foot, can also lead to similar stress, affecting the alignment of the spine.

Muscle imbalances are another culprit. Runners often develop strong quadriceps and weaker hamstrings and hip muscles, creating uneven forces on the pelvis and back. Additionally, inadequate core strength can fail to support the spine properly during the impact of running, leading to discomfort and pain.

External factors like running on hard surfaces can exacerbate the issue by increasing the impact on the spine and muscles. Unsuitable running shoes that do not provide adequate support or cushion can also contribute to the problem. 

How to Manage and Alleviate Pain

Addressing lower back pain requires taking several proactive steps, focusing on both prevention and immediate relief. Firstly, it's crucial to improve running form. Runners should aim for a relaxed, upright posture with a slight forward lean from the ankles, not the waist. Keeping the head and shoulders aligned over the hips can reduce strain on the lower back.

Strengthening exercises are pivotal. Core strengthening routines, such as planks and bridges, enhance spinal stability, while exercises like lunges and hamstring curls balance muscle strength around the pelvis. Incorporating flexibility and stretching exercises, particularly for the hamstrings and hip flexors, can also help maintain good pelvic alignment and decrease stress on the back.

Choosing the right footwear is essential. Shoes with appropriate support and cushioning can diminish the impact on the spine. Moreover, alternating running surfaces and avoiding excessive running on concrete or asphalt can prevent the exacerbation of pain.

When experiencing pain, immediate measures like applying ice or heat can offer relief. Ice reduces inflammation and numbs sharp pain, while heat can relax and soothe tight muscles. Over-the-counter pain relievers may be used judiciously to manage pain, although they should not be seen as a long-term solution. 

When to See a Pain Specialist

Lower back pain is a common issue among runners, which can often be managed through self-care and modified running practices. However, there may be certain situations where professional medical intervention is necessary. If a runner experiences any of the following symptoms, they should consult a pain specialist for further evaluation and treatment:

  • The pain persists despite taking preventive measures and resting.
  • The pain worsens or does not respond to home treatments.
  • The pain is severe and incapacitates them, or significantly affects their daily activities.
  • Symptoms extend beyond pain, such as numbness or tingling in the legs, indicating potential nerve involvement.

A pain specialist can provide more targeted treatments, such as physical therapy, advanced pain management strategies, or diagnostic imaging, to determine the underlying causes of pain and help prevent further damage. 


Lower back pain is a common issue for runners, but it is manageable. By understanding the causes of this problem, employing strategies to manage and alleviate pain, and knowing when to seek professional help, runners can continue to enjoy the benefits of their sport without the setback of back pain. Addressing the problem holistically with a focus on form, strength, flexibility, and appropriate equipment can lead to sustained improvements and a healthier running experience.