Running is one of the most rewarding forms of exercise—boosting cardiovascular health, enhancing mood, and improving overall fitness. However, for many runners, persistent back pain can make it difficult to enjoy or even maintain a consistent running routine. Whether you’re dealing with acute discomfort or chronic pain, back issues can seriously affect your performance and motivation.
One common cause of back pain for runners is facet joint dysfunction, an often overlooked but significant source of discomfort. In this post, we’ll explore the causes of back pain for runners, why facet joint issues are particularly common, and how treatments like facet joint injections can help you manage or eliminate pain—getting you back on track.
Causes of Back Pain in Runners
While facet joint dysfunction is a leading cause of back pain for runners, other factors also contribute to the discomfort many experience while running:
1. Facet Joint Dysfunction
The facet joints can become inflamed due to repetitive motion, overloading, or sudden trauma. Running, especially on hard surfaces or with poor form, can exacerbate the stress on these joints. Over time, this may lead to joint wear and tear, resulting in pain that worsens with movement.
2. Poor Running Form or Posture
Running with poor form places excessive strain on the spine and its surrounding structures. Runners who slouch, lean forward, or have an exaggerated forward tilt may increase pressure on the facet joints, contributing to pain.
3. Muscle Imbalances
Weak core muscles, tight hamstrings, and stiff hip flexors can all affect the alignment of the spine and increase stress on the facet joints. If the muscles around your spine and hips aren’t balanced, the facet joints may be forced to bear more load than they’re designed for.
4. Degenerative Changes
Over time, the facet joints may undergo degenerative changes, particularly if you’ve been running for many years or have experienced previous back injuries. Degeneration of the cartilage within these joints can lead to painful bone-on-bone friction, further aggravating symptoms.
5. Spinal Alignment Issues
Issues like scoliosis (curvature of the spine) or uneven leg lengths can affect the alignment of your spine, leading to increased stress on the facet joints and other structures in your back. For runners, this misalignment can create discomfort, especially during long or intense runs.
6. Overuse Injuries
Running too much too soon or increasing mileage too quickly can put excessive strain on the body. Repetitive stress from running without proper recovery time can contribute to facet joint irritation, disc issues, or other spinal injuries.
What Are Facet Joints?
The facet joints are small joints located along the back of the spine, where the vertebrae meet. These joints allow for flexibility and movement, providing stability while enabling you to bend, twist, and extend your spine. They also help to absorb shock during movement, including activities like running.
When the facet joints become inflamed, irritated, or damaged, it can lead to localized pain in the back. Facet joint pain is typically felt in the lower back or the neck, but it can also radiate into the legs. In runners, facet joint dysfunction can stem from overuse, poor posture, muscle imbalances, or injury.
Symptoms of Facet Joint Pain
Facet joint pain can manifest in various ways, and its symptoms may be more pronounced for runners, especially when they’re on their feet for extended periods. Common signs of facet joint dysfunction include:
- Lower back pain: Usually localized to one side but may spread across the back.
- Pain that worsens with activity: The pain may intensify when running, walking, or even standing for long periods.
- Pain that improves with rest: Unlike muscle soreness, facet joint pain often improves with rest and worsens with movement.
- Stiffness and limited range of motion: Difficulty bending or rotating the back may accompany facet joint pain.
- Radiating pain: Pain may also radiate to the buttocks, hips, or thighs, similar to sciatic pain.
- Tenderness over the facet joints: When pressing on the area of the spine where the facet joints are located, the pain may increase.
Treatment Options
When running with back pain, it’s crucial to address the root cause of the problem to prevent it from becoming a chronic issue. There are several treatments that can help alleviate pain and improve function, ranging from conservative methods to more advanced interventions like facet joint injections.
Conservative Treatments
- Rest and Recovery: Taking short breaks from running and allowing the body to heal is essential. Cross-training with lower-impact activities like swimming or cycling can help maintain fitness while reducing strain on the back.
- Physical Therapy: A physical therapist can develop a personalized rehabilitation program focusing on strengthening the core, improving posture, and addressing muscle imbalances. Specific exercises may help support the spine and relieve pressure on the facet joints.
- Stretching and Mobility Exercises: Regular stretching, yoga, or foam rolling can help alleviate tension in the muscles surrounding the spine, improve flexibility, and reduce strain on the facet joints.
- Pain Management: Over-the-counter anti-inflammatory medications (e.g., ibuprofen) can reduce inflammation and pain associated with facet joint dysfunction. Ice or heat therapy can also be effective for managing flare-ups.
Facet Joint Injections
If conservative treatments aren’t enough to alleviate pain, facet joint injections can be a highly effective option for treating facet joint dysfunction, especially in runners dealing with chronic or severe pain.
Facet joint injections involve the injection of a local anesthetic and corticosteroid directly into the facet joint. This can provide immediate pain relief by numbing the joint and reducing inflammation, giving the runner a reprieve from pain and allowing them to regain mobility.
Benefits of Facet Joint Injections
- Pain Relief: The local anesthetic provides immediate relief by numbing the pain at the joint.
- Reduced Inflammation: The corticosteroid reduces inflammation, which can last for weeks to months, helping the joint heal and preventing further irritation.
- Improved Function: With reduced pain and inflammation, you may experience improved mobility and function, allowing you to resume running more comfortably.
- Diagnostic Tool: In some cases, facet joint injections can also help confirm whether the facet joints are the primary source of your pain
- Minimally invasive: Typically performed under fluoroscopy (X-ray guidance), this is a minimally invasive procedure that requires little downtime.
Preventing Future Back Pain
Even after successfully treating facet joint pain, it’s essential to take steps to prevent future flare-ups:
- Maintain proper running form: Focus on posture and stride mechanics to reduce stress on the back.
- Strengthen your core: A strong core supports the spine and helps prevent overloading the facet joints.
- Avoid overuse: Gradually increase your running mileage and allow time for rest and recovery.
- Cross-train regularly: Mix up your routine with lower-impact activities to give your back a break.
Conclusion
Running with back pain, especially facet joint dysfunction, can be incredibly frustrating. However, with the right treatments, including facet joint injections, physical therapy, and proper preventative measures, you can manage your pain and continue running without limitations. If you’re struggling with back pain that impacts your running, contact our office to schedule a consultation with one of our providers. Dr. Thomas Weber is a board certified and fellowship trained in Anesthesiology and Pain Management.
