Sharp Lower Back Pain Causes and Diagnosis

Midsection Of Patient Suffering From Backache On Bed In Hospital
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Most of us have been seized by a sharp pain in the low back area at some point. If this has ever happened to you, you may have wondered what in the world caused it and more importantly, what you could have done to relieve it.

Perhaps most critical of all, you may have wanted to know if it was serious enough to warrant medical attention.

Clarifying the answers to these questions quickly is key to staying well. If your sharp lower back pain requires medical treatment, you'll be in a position to begin in a timely way. Otherwise, your acute, short term problem may evolve into a chronic condition. Early diagnosis and treatment is perhaps the best thing to go for if you want to avoid a long term problem.

Causes of Sharp Low Back Pain
Verywell / Gary Ferster

Sharp Pain in Your Lower Back

"A sharp lower back pain is a symptom that has a wide variety of possible causes," says Dr. Kathleen Fink. Fink specializes in physical medicine, rehabilitation and pain management at the MedStar Clinic in McLean, Virginia.

She explains, "back pain is like a big black box. With limited access to the contents of that box, your doctor is tasked with figuring out what’s inside. And there are many, many things that can cause it."

Whether or not you can get to the bottom of your sharp lower back pain will likely depend on the location of the pain, if you feel it is only in one place or in several if it moves around, and what types of movements make it worse, she says.

Dr. John Toerge, professor of medicine at Georgetown University and practicing osteopathic physician at MedStar in Bethesda, Maryland adds that sharp, piercing and/or knife-like pain is usually associated with an acute mechanical problem in the spine.

"Most of the time, sharp low back pain occurs when you try to move your spine," he comments. Resting often helps reduce the pain, as may the use of a back brace, he says.

"Structurally, the joints work to dissipate forces that come to them. If there’s a physical restriction in the joint, or it’s working less efficiently than usual for some other reason, you may feel binding or pinching in that area." Toerge says this is true of almost all joints, not just those in the spine.

Both Toerge and Fink agree that some of the most common causes of sharp low back pain include the following:

Muscle Strain

Most of the time, sharp lower back pain is due to a muscle strain, Fink offers. Along with the sharp pain, you may also experience other symptoms.

Facet Joint Pain

Facet joint pain is often related to the mechanical problems with the spine as Dr. Toerge mentioned above. Facet joints are located at the back of the spine and help to keep the entire column connected and upright. Often the site of spinal arthritis, these joints are easily injured during motor vehicle accidents.

Spondylolysis and Spondylolisthesis

These related conditions generally do not themselves cause sharp low back pain, Toerge says. But when extensive damage or aggravation of either set in, the facet joints may be affected. These conditions may leave the back feeling stiff or strained.

Spinal Fracture

Another type of mechanical problem that can lead to sharp lower back pain is a spinal fracture. In fact, according to Toerge, spinal fractures are about the sharpest and most irritating type of back pain of all. Toerge explains that the rich nerve supply that serves the bones is an excellent relayer of pain signals.

Sacroiliac Joint Dysfunction

Sharp low back pain may or may not accompany sacroiliac dysfunction, says Toerge. Sometimes SI joint pain is duller in nature than sharp, he adds. Toerge also says that the type of sacroiliac pain you may experience is likely related to the extent of the damage to the joint.

Other Causes of Sharp Low Back Pain

Other spinal structures sometimes responsible for sharp low back pain include ligaments and intervertebral discs. Again, because there are a lot of nerves in the spine, the potential for pain in these areas, is there, Dr. Toerge comments.

This list is just to give you a general idea about potential causes of sharp low back pain. If you experience this or any type of pain, be sure to consult your doctor.

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Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Medstar Health. Dr. Kathleen Fink, MD. Updated 2019.

  2. National Institute of Neurological Disorders and Stroke. Low back pain fact sheet. Updated December 2014.

  3. Key, J. Back pain: a movement problem. New York, New York: Elsevier Health Sciences; 2010.

  4. UCLA Health. Facet joint syndrome. Updated 2019.

  5. American Academy of Orthopaedic Surgeons. Spondylolysis and spondylolisthesis. Updated September 2016.

  6. Cleveland Clinic. Spinal fractures. Updated 2019.

  7. Peebles R, Jonas CE. Sacroiliac joint dysfunction in the athlete: diagnosis and management. Curr Sports Med Rep. 2017;16(5):336-342. doi:10.1249/JSR.0000000000000410

Additional Reading

  • Fink, K., MD, Attending Physician. National Rehabilitation Hospital, Washington, DC. Telephone Interview. May 12 2011.

  • Toerge, J. DO, Medical Director Musculoskeletal Institute National Rehabilitation Hospital, Washington, DC. Telephone Interview. June 7 2011.