Can I Run With Lower Back Pain?
By Mark Howlin
Associate Physiotherapist, Musculoskeletal & Sports Injuries (BSc, MSc, GEMt) · Registered with the AHPRA (PHY0004060355)
Mark Howlin is an Associate Physiotherapist at Physio K, with a focus on sporting injuries and post-operative rehabilitation, with advanced dry needling training from Ireland and Sydney. Across six years of clinical practice in Ireland and Australia, he has developed particular experience in chronic conditions such as anterior knee pain and Achilles tendinopathy, and acute lower limb muscle strains, using an integrated approach combining manual therapy, dry needling, and progressive rehabilitation. He has also served as team physiotherapist to elite GAA athletes, including during a championship-winning run at Croke Park
Last reviewed: 06 November 2026
Most runners with lower back pain can stay active, but running should be modified rather than forced through worsening symptoms. Reduce your speed, distance or frequency, keep discomfort mild and settling within a day, and seek physiotherapy assessment if symptoms persist, spread into your leg or repeatedly flare after running.
Key Takeaways
Lower back pain in runners often reflects training load outpacing the body's capacity to adapt, not structural damage
Pain between 0 and 3 out of 10 that settles within 24 hours is usually manageable; higher or persisting pain signals the need to reduce load further
Gradual strength training for the trunk, hips and legs supports capacity, while sudden jumps in distance or frequency raise injury risk
Complete rest is rarely needed; modify your running and stay active with walking or cycling while symptoms settle
Why Running Causes Lower Back Pain
Your lower back may hurt during or after running because the load you are placing on it currently exceeds what the tissues can tolerate. That does not mean the spine is damaged. People of all ages take up running for different reasons, whether to improve fitness, manage weight or support their mental health, and it can be frustrating when pain appears in something that is meant to be good for you. Often the discomfort starts a few weeks into a new program, or after a sudden increase in how far or how often you run. The muscles, joints and connective tissues in your back need time to adapt to the repeated impact and movement of running, and when the demand rises faster than your body can keep up, pain is the signal that tells you to ease off.
A 2020 systematic review in BMC Musculoskeletal Disorders found that reported low back pain prevalence and incidence in runners vary considerably across studies, reflecting differences in populations, definitions and study methods. The causes are usually multiple: training volume, recovery time, hip or trunk strength, previous injury, sleep, stress and the surfaces you train on can all play a part.
In the first session, I spend most of the time listening. I am not hunting for one structure that is broken, I am gathering the full picture of what is likely feeding the problem, which is almost always more than one thing. By the time I get hands on, the treatment plan rarely stops at exercises. Half the time it is a few subtle changes to how someone is living day to day, alongside the targeted rehab, because the rehab on its own was never going to be enough to shift something with that many contributors behind it.
Should I Run Through the Pain?
A common question I hear is "should I run through the pain?" The answer depends on the level and pattern of discomfort. Like anything, your body needs time to adapt. If you increase the stimulus too early, running may feel manageable for a little while, but as the demands rise and begin to outweigh your tissue capacity, pain tends to strike. Keep pain levels manageable, below 2 to 3 out of 10. If you are consistently surpassing this while running, things will typically get worse. As time goes on and your back continues to adapt, your capacity will increase and suddenly a distance that was once painful will not be anymore.
Mild, stable discomfort that does not change your stride and returns to baseline by the next morning may be acceptable during a graded return. Pain that progressively increases during the run, spreads below the knee, causes numbness or weakness, or remains worse for more than 24 hours means the load is currently too high and you need to reduce your running further or stop temporarily.
When to Seek Urgent Help
Stop running and seek urgent medical assessment if you experience severe or rapidly worsening back pain, loss of bowel or bladder control, numbness around the saddle area between your legs, progressive weakness in one or both legs, fever, unexplained weight loss, major trauma such as a fall from height, or if you have a history of cancer. These symptoms may indicate a serious condition that requires immediate attention, not self-management.
What the Research Shows
A 2022 systematic review in the Journal of Orthopaedic & Sports Physical Therapy found that walking or running provides a small benefit compared with minimal or no intervention for chronic or recurrent low back pain. The research team, led by Pocovi and colleagues, noted that staying active through running is generally more helpful than avoiding movement altogether. The 2021 clinical guideline from the Journal of Orthopaedic & Sports Physical Therapyrecommends exercise interventions, including trunk strengthening and endurance, aerobic exercise and general exercise, as options for chronic low back pain.
People who have usually just picked up running tend to ask most about this topic, and they often find it hard to understand their pain. Behind the question is usually a lot of curiosity: you picked up running, which is meant to be good for you, and now you are in pain. It can be people of all ages exercising for different reasons, and the pain often comes hand in hand with anxiety, as people feel this will be a stumbling block between them and achieving their health and fitness goals. In my experience, if the pain is quite new onset, something as simple as a de-load and load management can be enough to keep symptoms controlled. As pain progresses, it can take longer for it to settle and may require more intervention.
What You Can Do
Reduce your next few runs by roughly 20 to 50 per cent in distance or time, and remove hills, sprints or other features that worsen your symptoms. This lowers the load while preserving your routine. If pain continues to worsen or does not settle within 24 to 48 hours, arrange a physiotherapy assessment.
Keep moving with comfortable walking, cycling or prescribed exercises rather than prolonged bed rest. Gradual activity supports recovery. Stop and seek urgent help if you develop progressive weakness, numbness around the saddle area, or bowel or bladder changes.
Add two weekly strength sessions covering trunk endurance, hip and leg exercises, progressing gradually over several weeks. This builds your capacity to handle running loads. Track your pain during the run and the following day. If symptoms change your stride, spread into your leg or repeatedly flare after running, book an assessment at Physio K.
Common Questions
Can I run with lower back pain?
Yes, most people can continue running with lower back pain if they modify their training. Reduce your distance, speed or frequency so that discomfort stays below 2 to 3 out of 10 and settles within a day. If pain worsens during the run, alters your stride or does not settle overnight, you need to reduce the load further or stop temporarily and seek assessment.
How long until I can train normally?
Recovery time depends on how long you have had symptoms and how well you manage your training load. If the pain is new and you reduce your running early, symptoms often settle within a few weeks. If pain has been present for longer or keeps flaring, it may take several weeks to a few months of modified training and strengthening before you can return to your previous volume. Tissue capacity may still be some way off tolerating the demands that caused the problem in the first place, which is why a structured, graded return is safer than jumping straight back to where you left off.
What happens during a physiotherapy assessment?
During the first session, your physiotherapist will spend most of the time listening to understand the full picture of what is feeding the problem. This includes your training volume, recovery time, hip or trunk strength, previous injury, sleep, stress and the surfaces you train on. The treatment plan usually combines targeted exercises with adjustments to how you are living day to day, because the rehab on its own is rarely enough to shift something with multiple contributors behind it.
Reviewed by Kenny Merlevede. Kenny Merlevede is a Senior Physiotherapist with 18 years of experience in private practice, with a focus on complex cervical presentations and persistent musculoskeletal conditions. Registered with the Australian Health Practitioner Regulation Agency (PHY0002060505).
This article is for general information only and is not a substitute for personal medical advice. If you have concerns about your health, please consult a qualified clinician or your GP.
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