Should I call it quits?

? Until about three years ago, I'd been running for 20 years, 20 to 25 miles per week. I did a couple of marathons in my 50s. I'm now 68 years old, 6' 1" and 170 pounds (male). I only run 3 miles 2 or 3 times a week, and occasionally ride a bike. I have arthritis in my lower back. A recent X-ray found "near-complete loss of disc at L3-L4 with additional disc narrowing at L4-L5. There are ventral and lateral osteophytes at L3-L4 with a vacuum cleft identified. There is mild retrolisthesis of L4 on L5. Some proliferative or sclerotic changes of the L4-L5 and L5-S1 facet joints are likely." I have morning stiffness and find myself bent over for a few steps after getting up from a sitting position, but I have no particular discomfort in my back while running. Am I aggravating or speeding the advance of the arthritis by running?

Richard Day, Raymond, ME

I am surprised your running has not caused any increased arthritic symptoms or degenerative changes in your lumbar spine. I feel that it is just a matter of time before it does. I think that high impact activities like running are putting significant stresses on a part of your skeleton that is no longer able to accept the stress. I therefore recommend that you do your best to find an alternative, such as swimming or biking (as you've indicated you participate in), or even a Nordic Track-type ski machine, and restrict your running.

Martin M. Pomphrey, Jr., MD, Starkville, MS

There are several good studies available that show that running does not accelerate the progression of degenerative (osteo) arthritis and may, in fact, slow the progression of the disease. As long as you are not having undue discomfort related to your running, I think that continuing to run will help you to control your weight, thereby reducing the stress placed on your lower back, and will help maintain the integrity of your remaining cartilage. I think you may continue to run vigorously without fear of worsening the degenerative arthritis of your spine, and you will even likely slow the progression of the condition. If your back pain worsens or the pain moves down your legs, however, I suggest you have a re-evaluation of your lumbar spine by your physician.

Dennis D. Daly, MD, Camillus, NY

Runners rarely develop degenerative back problems from running. No studies that I'm aware of have shown this. Runners can develop back problems that keep them from running. My advice is to seek proper physical therapy to help keep you running as long as possible. If you eventually develop worsening back symptoms that keep you from running and your back does not respond to treatment, then it's time to give up running. Do not give up fitness walking, however. Never get to the point where you cannot walk for exercise.

Bruce Wilk, PT, OCS, Miami, FL