What to Do When Walking Causes Lower Back Pain

The Most Common Types of Back Pain

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When walking hurts

Walking is a great thing you can do for your health. Aiming for at least 10,000 steps a day is even better.

The benefits for your heart, lungs, and mental health are well-known, but sometimes there can be a downside—walking may cause or worsen lower back pain.

As many as 80 percent of people in the United States will develop back pain at some point in their lives, making it the third most common reason for doctor visits, according to the American Chiropractic Association.

“Walking or standing for extended periods, can cause strain in the back muscles, especially those that support the lumbar [low back] region, resulting in pain and tension,” explains Gbolahan Okubadejo, MD, a New York City orthopedic surgeon. “This is why long lines can be so stressful. It’s not just impatience; it’s physical strain.”

(Find out your walking IQ.)

There are many structures in your back that can cause pain and potentially be triggered by walking, including muscles, tendons, ligaments, nerves, bones, and joints. If you have bad posture or are overweight or obese, you may be at greater risk for back pain while walking. Back pain can be acute (lasting 4 to 12 weeks) or chronic (lasting 12 weeks or more), the Centers for Disease Control and Prevention (CDC) explains.

Here are the reasons you can get lower back pain when walking.

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Muscle fatigue

If you’re overweight or obese, you are more likely to experience back pain when walking, and this is due to muscle fatigue.

Causes

Your lower back carries most of your body’s weight when you walk. It’s not always easy to carry extra pounds, and as a result, your muscles can get worn down. This may cause pain with prolonged standing or walking, says Dr. Okubadejo.

Symptoms

Your back may ache when you are walking or standing, but the pain likely subsides when you sit or lie down.

Diagnosis and treatment

Your doctor will perform a physical exam and may order imaging tests to see what is causing your back pain. “Most back pain is nonspecific, meaning we can’t find an identifiable structure that is causing your pain,” says Jake Magel, PhD, a physical therapist and research assistant professor at the University of Utah in Salt Lake City.

If your weight appears to be causing muscle fatigue and pain when walking, weight loss is the solution. “Weight loss will make a big difference in walking-related back pain,” Dr. Okubadejo says. Strengthening exercises to stretch and loosen tight muscles will also help build the muscles that support your back, he says. Hot or cold therapy, over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can also aid an achy back.

(Learn more about the best OTC pain reliever for every ache.)

Sciatica

Sciatica occurs when there is damage to, pressure on, or inflammation of your sciatic nerve, which runs from your lower back through your hips and buttocks, down your legs, and into your feet

Causes

If your sciatic nerve is pinched or compressed due to your gait, it can cause pain, numbness, or weakness up and down your leg, explains Jordan D. Metzl, MD, a sports medicine physician at the Hospital for Special Surgery in New York City and author of several books, including Dr. Jordan Metzl’s Running Strong: The Sports Doctor’s Complete Guide to Staying Healthy and Injury-Free for Life.

Other back problems, such as spinal stenosis (more on that below) or herniated discs, can result in sciatic pain, he says. With the latter condition, one of the discs that serve as shock absorbers between each vertebra may slip or herniate, putting pressure on your sciatic nerve. This may happen with age, or from a strain or twisting movement, Dr. Metzl says.

Symptoms

Sciatica may cause burning, tingling, numbness, radiating pain, or electric shock-like sensations, Dr. Metzl says.

Diagnosis and treatment

Your doctor will ask about the pain and when it first started and will conduct an exam to identity the pinched nerve. Sometimes X-rays or other imaging tests can help confirm the presence and location of the compressed nerve.

Physical therapy, NSAIDs, and sometimes steroid injections may help relieve this pain, Dr. Metzl says.

Spinal stenosis

Spinal stenosis is a narrowing of the spine that can place extra pressure on the spinal cord and nerves.

Causes

Your risk of developing spinal stenosis increases with advancing age. Osteoarthritis, the wear-and-tear form of arthritis, may also contribute to the narrowing of your spine. (These are the everyday habits that are damaging your spine.)

Symptoms

Spinal stenosis doesn’t always cause symptoms, but it can make walking long distances painful. If there is pressure on your sciatic nerve as a result of the narrowing, you may experience pain, numbness, tingling, and other symptoms that can affect your ability to walk too.

Diagnosis and treatment

Your doctor will perform a thorough physical exam that includes feeling your back and asking you to bend forward, backward, and side to side. Imaging tests may also be needed. Treatment typically includes physical therapy and taking NSAIDs, followed by steroid injections if OTC pain relievers don’t do the trick. Surgery is considered a last resort for spinal stenosis.

Strains and sprains

A sprain is an injury or tear to a ligament that connects two or more bones at a joint, while a strain is an injury to a muscle or tendon.

Causes

If your gait is off, the resulting abnormal movement can cause a strain or sprain in your back. This can also occur if you fall or twist suddenly while you are walking. If you are overweight, you are at higher risk of developing lower back sprains and strains.

Symptoms

Sprains and strains can cause pain, swelling, bruising, cramping, spasms, and/or trouble moving.

Diagnosis and treatment

Your doctor will ask you questions about your pain and when it first started, examine the area, and possibly order X-rays to rule out any broken bones. In general, staying active, taking NSAIDs, and participating in physical therapy will relieve lower back pain from strains and sprains. A gait evaluation by a physical therapist, biomechanical specialist, or kinesiologist, followed by changes to how you walk, may help stave off future sprains and strains.

Muscle spasms

A sudden, involuntary contraction or twitch in one or more of your muscles is known as a spasm.

Causes

If there is increased pressure on your spine, your lower back muscles may tighten and spasm, leading to pain, says Dr. Metzl. This could occur when you are walking, especially if you accidentally step into a pothole or are yanked by your dog when a squirrel darts across your path.

Symptoms

Muscle spasms come on quickly and often go away just as quickly, he says.

Diagnosis and treatment

Tell your doctor about your pain and when it tends to occur. You may need some imaging tests as well. As with other types of low back pain, staying active, taking NSAIDs, and taking part in physical therapy can usually help muscle spasms. Heating pads can help relax muscle spasms.

Lordosis

This is the medical name for a C-shaped curve in your lower back

Causes

Lordosis can be caused by the brittle bone disease osteoporosis, obesity, and spinal injuries.

Symptoms

Lordosis affects your posture and may lead to pain while you are walking.

Diagnosis and treatment

Your doctor will perform a physical exam to determine if there are any abnormalities in how and where your spine curves. You will likely need X-rays too. Treatment may include medication, physical therapy, weight loss, and possibly bracing. If osteoporosis is the cause, your doctor may suggest medications to help preserve your bone. (These 8 habits may be contributing to osteoporosis.)

Poor posture

Poor posture can cause you to hunch forward when you walk.

Causes

There are many potential causes of poor posture, including stress, obesity, pregnancy, weak core muscles, tight muscles, high-heels, and improper sitting at your workstation.

Symptoms

Poor posture can place increased pressure on your backbone. This, in turn, can affect your muscles, discs, joints, and nerves, causing pain and possibly sciatica.

Diagnosis and treatment

If your posture is responsible for back pain while walking, a doctor, chiropractor, or physical therapist can suggest exercises to strengthen your core and improve your posture. As a general rule, “Don’t slump, hunch, or lean too far forward,” says Dr. Okubadejo.

Lifestyle interventions

Losing weight if you are overweight or obese is one of the best ways to reduce your chances of developing back pain while walking, according to Dr. Okubadejo. “Keeping a healthy weight can also reduce stress on the back and legs,” he says.

(Here are 8 easy strategies to use walking for weight loss.)

“Consume a healthy, balanced diet that includes lean protein, fruit, whole grains, and vegetables,” says Dr. Okubadejo. “Light and slow exercises can loosen and stretch tight muscles,” he says.

Hot or cold therapy and NSAIDs are also helpful. “When your back pain is acute [less than a four-week period)] and/or occurs due to a direct injury, use cold therapy first, as lowering the body temperature will help constrict the blood vessels, reduce swelling, decrease inflammation, and cause a numbing effect,” Dr. Okubadejo says.

Once the inflammation has subsided, use heat therapy. “When you apply heat, it improves the flexibility of soft tissues, movement of muscles, and overall functioning of the back,” he explains. “The warmth stimulates blood circulation in your lower back, which in turn brings healing nutrients to the injured tissues.”

(These are the walking shoes podiatrists recommend.)

The last word

The benefits of walking far outweigh any risks. If your back hurts while you are walking, talk to a doctor or physical therapist to see what is causing your pain and what tweaks you can make to feel better and reap the benefits of walking.

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