People who run or walk regularly have healthier and stronger spinal discs than non-exercisers do (Scientific Reports 7, April 19, 2017). This is very reassuring because some doctors tell patients with back pain not to run because they think that the jarring of the foot striking the ground will damage discs and injure backs, even though there is no good data anywhere to support such opinions. However, if your back hurts when you run, you should stop running.

disc problemsThe vertebral bones of the spine are separated by pads called discs that absorb the shock of hard exercise such as running or lifting weights. The nerves that supply your body pass out from the spine between the vertebral bones where the discs are located. With aging or inactivity, the discs weaken and can be squashed between the much tougher vertebral bones. A squashed disc can protrude between the vertebral bones and may pinch nerves to cause excruciating pain.

Scientists have known for hundreds of years that lack of exercise weakens muscles and bones, while exercise strengthens them (Sports Med, 2016;46:1165–1182), but until recently, no good studies have shown that exercise also strengthens discs. Some doctors believe that rapid movements and pressure will damage discs, but several animal studies show that a regular exercise program strengthens discs (Eur. Spine J, 2011;20:1796–1812), makes discs larger and stronger (Spine, 2012;37:1440–1447) and strengthens discs in rat spines (Spine, 2010;35:1429–1436). Now we have data that a regular exercise program strengthens human discs and is probably the most effective means of treating many cases of back pain caused by weak or damaged discs (Sports Med, 2016;46:473–485). We also have strong MRI data that people who run or walk regularly have larger and stronger discs that contain more fluid to pad and protect them from injury (Scientific Reports 7, April 19, 2017).

Back Surgery Has an Incredibly High Failure Rate
A spinal fusion includes surgery to remove at least part of a disc and a bone graft to fuse the upper vertebral bone to the lower vertebral bone. Many reports show that regular back exercises are usually more effective than this surgery to treat back pain caused by disc compression (Ann Rheum Dis, 2010;69:1643–1648). In spite of this, the number of spinal fusions performed in the U.S increased progressively until 2012. Then the rates of spinal fusions decreased, primarily because Blue Cross of North Carolina and several other insurers refused to pay for the procedure (The Spine Journal, February 1, 2015;15(2):265–271). This implies that the rate that some surgical procedures are done is driven by insurers’ willingness to pay for a procedure.

My Recommendations
• If you have back pain, you should check with your doctor for a specific diagnosis and treatment.
• Specific daily back exercises are the primary treatment for most causes of chronic back pain. Realize that some conditions can be worsened by exercise.
• If you have a condition that is treated with exercise, you should get instructions from a physical therapist who can teach you specific belly and back exercises and how to use exercise machines properly. Improper exercise can worsen your condition.
• Start off with very low resistance and stop immediately for the day if the pain worsens. The best indicator of damage from exercise is pain. Listen to your body.
• Try to exercise every day and do not do anything that increases pain in the injured area.

Checked 8/9/23