Running and Back Pain: Why It Happens and What May Help

Research suggests running is associated with less low back pain than many people expect, and it may even be protective. A 2020 systematic review of studies on runners found low rates of low back pain among them and cautiously concluded that running could be considered a protective factor. That is close to the opposite of the common worry that mileage is hard on a back, and it is worth knowing before you give up a routine you enjoy.

So why do some runners still develop back pain? When it does happen, it tends to cluster around controllable factors: a training load that jumped too fast, skipping warm-ups, fatigue, and a lot of sitting time outside of running. One high-incidence study in that review stood out precisely because its runners sat 50 to 75 percent of the day, which points at sedentary hours rather than the run itself as the risk factor. In marathon runners specifically, researchers have linked back pain with a lack of warm-up, fatigue and poor running posture.

The evidence also says activity itself can be part of the answer. A 2024 randomized trial called ASTEROID found that a progressive run-walk program was an acceptable and effective approach for adults with chronic low back pain, improving pain and disability compared with a waitlist group. And strengthening the core and glutes is among the exercise types with the best evidence for chronic back pain, so a simple home routine can support the miles you already run.

A practical approach: build mileage gradually, warm up before harder sessions, alternate run-walk intervals when the back is cranky, and keep up with core and glute work. If pain is sharp, keeps returning, or travels down a leg, stop and have it looked at rather than running through it.

Chiropractic care may help some runners by keeping the spine, hips and legs moving well as part of the larger training system, not as a replacement for strength work or recovery. Dr. Gregory Martin is the official chiropractor of Parisi's Speed School of Morris Plains and has cared for active people and athletes since 1996. He sees patients at his office at 283 Sparta Avenue in Sparta and at Speedwell Family Chiropractic at 520 Speedwell Avenue in Morris Plains.

If your back is talking during your runs, an evaluation is the honest way to find out what is going on. Call or text (973) 699-4100 to schedule one.