INTRODUCTION: Running is one of the most common sports practices in the world due to the beneficial impact on the health, despite the relatively high risk of getting injuries. In fact, running is one of the most common sports capable to induce overuse injuries of the lower back and leg. In previous studies, the symptoms in the lower limb have been attributed to lumbosacral degenerative pathology. When the symptoms are unclear, they must be studied with great attention by carrying out an accurate process of screening and differential diagnosis. MATERIALS AND METHODS: A 42-year-old non-competitive male runner who complained of left leg pain was referred to a physiotherapist. He reported a continuous, deep, sharp, shooting pain of the left leg. The symptoms began one year earlier. Symptoms worsened during prolonged driving and long distance running. The patient had been previously diagnosed with lumbar radicular irradiation in the leg by a general practitioner. Initial management, in another physical therapy outpatient setting, was without any improvement. RESULTS: After surgical excision, symptoms gradually regressed shortly and the patient was referred to a physiotherapist in order to fully recover and restore work and running activities. CONCLUSION: This case report describes the history, assessment and treatment of a runner with a rare cause of leg pain. After surgery excision, treatment focused on education and loading the tissues over many weeks through a graded program of loaded exercises and running retraining.