Active Adults

Running and Lower Back or Hip Pain: Should You Push Through It?

Reviewed by Dr. Dustin Dukart, DC

Most running aches are a load problem — you asked the body for more than it was ready for, a little too fast. That’s usually manageable without stopping entirely. A few are worth taking seriously. Here’s how to tell them apart.

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A simple pain rule: for an ache already checked out as nothing serious, pain that stays at or below 3/10, doesn’t worsen as you go, and settles within 24 hours is usually okay to train around. Pain that climbs, worsens, or changes your stride means back off and get it looked at.

The Load Story

The strongest predictor of a running injury isn’t your form or your shoes — it’s a rapid spike in training load: a sudden jump in weekly mileage, back-to-back hard days, a lot of new hill or speed work, or coming back from a break at the volume you left off at. The old “10% per week” rule is a rough guide, not a law, but the principle holds: change one variable at a time and give the tissues time to adapt.

A Simple Pain Rule

For an ache that’s clearly muscular or joint-related and has been checked out as nothing serious, a common approach is: pain during the run that stays at or below about 3 out of 10, doesn’t get worse as you go, and settles within 24 hours is usually okay to keep training around — often at reduced volume or intensity. Pain that climbs past that, worsens through the run, makes you limp or change your stride, or is still there the next morning is a signal to back off and get it looked at.

What Usually Helps

Cut volume by a third to a half for a week or two rather than stopping cold — relative rest keeps fitness and often calms the tissue faster than total rest.
Swap some runs for cycling, swimming, or an elliptical to keep the aerobic base.
Add targeted strengthening for the hips, glutes, and trunk — this is where most durable running-injury prevention actually lives.
Rebuild mileage gradually once pain settles.

When to Get It Checked

Book an exam if hip or back pain has lasted more than a week or two, keeps returning at the same point in a run, or is changing your stride. See a physician promptly for a pinpoint bony ache that hurts to hop on or press (possible bone stress injury), pain with numbness or weakness down the leg, night pain, fever, or — in a runner with low energy availability or menstrual changes — any suspicion of a stress fracture.

Nagging Running Pain?

Most new patients are seen within a few days. Related: hip pain, low back pain, and sciatica.