Causes and Risk Factors of Sharp Low Back Pain

Midsection Of Patient Suffering From Backache On Bed In Hospital
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Low back pain that's sharp and severe tends to come on suddenly and to be acute—that is, lasts for no longer than three months. Potential causes of sharp low back pain range from a sudden injury such as a spinal fracture or sprain to degenerative damage to vertebral discs to sciatica, among others. When the precise cause of sharp low back pain cannot be identified, it falls into the category of "non-specific" back pain.

Whatever the cause, low back pain is a common complaint: An estimated 80% of adults experience an episode of low back pain at some point in their lives. Most times, it will resolve itself within a few days or weeks.

Causes of Sharp Low Back Pain
Verywell / Gary Ferster

Common Causes

Sharp, piercing pain usually is associated with a problem in the spine that occurs as a result of a simple, seemingly benign movements such as twisting or lifting something heavy.

Muscle Strain

A strain is an injury in which tendon or muscle fibers are overstretched or torn, triggering inflammation. When the low back is affected, the pain often emanates from the buttocks and may extend down the back of one or both legs.

Other symptoms of muscle strain include stiffness, muscle spasms, and difficulty moving.

Muscle Sprain

A lower back sprain, also called a lumbar sprain, occurs when ligaments—the tough bands of tissue that connect bones to bones—are torn from their attachments. Sprains can result from stretching or tearing a ligament, oftentimes due to an injury such as a fall or some action that displaces the surrounding joint from its normal alignment.

A sprain can range from a mild ligamentous stretch to a complete tear. Bruising, swelling, instability, and painful movement are common symptoms experienced after a sprain occurs. A sprain, like a strain, may cause painful muscle spasms.

Facet Joint Pain

Facet joints are located behind the vertebrae and help to protect the spine from extreme movements in any direction. They can be injured by a sudden jolt, such as whiplash, in which the spine is pulled out of alignment. Even the simple action of bending over to tie a shoelace can trigger facet joint pain.

Facet joints also are susceptible to degenerative arthritis (osteoarthritis), in which the cartilage that surrounds and cushions each joint wears out, eliminating protective cushioning between the vertebrae. Pain can be felt when the bones rub against each other.

The sharp pain caused by facet joint injury or degeneration can radiate from the lower back down to the buttocks and upper legs or up to the shoulder blades. You may feel as if your spine has "locked up" and even be unable to move for a few minutes.

Spinal Fracture

A spinal fracture—also known as a compression fracture—occurs when vertebrae collapse under the load of an external force. This is common in traumatic spinal injuries or after a bad fall when a vertebra is squeezed or crushed.

In older adults, such fractures may be caused by loss of bone density associated with osteoporosis.

Spinal fractures tend to cause sharp low back pain when a person is standing. Vertebral fractures due to osteoporosis may not cause symptoms at first.

Sacroiliac Joint Dysfunction

The two sacroiliac (SI) joints located on either side of the lower back between the sacrum and the pelvic bones act as shock absorbers, decreasing stress on the pelvis and spine. When you stand or walk, the SI joints help transfer the load from your upper body to the lower body. Repetitive stress from daily movement or injury can wear down the cartilage around the SI joints causing low back pain and limited motion in the lower back or hips.

The intensity of sacroiliac pain typically is related to the extent of damage to the joint. When this cartilage is damaged or worn away, the bones begin to rub against each other. 

Movements or positions that stress the joints—such as standing up from a sitting position, walking upstairs, turning over in bed, or bending and twisting—can worsen pain in the lower back and hips. That pain may radiate to the groin, thigh, below the knee, or buttocks.

Activities such as running or jogging that subject the body to continuous and repetitive pounding can also lead to sacroiliac joint pain. Injury or trauma to the ligaments surrounding SI joints, spinal surgery, uneven leg length that affects walking patterns, or pregnancy also can trigger SI joint pain. In the case of pregnancy, any damage usually is temporary and resolves after a woman has delivered her baby and is no longer carrying around extra weight.

Sciatica

Sciatica occurs when there is pressure or damage to the sciatic nerve, which starts in the lower back and runs down the back of each leg. The sciatic nerve controls the muscles in the back of the knee and lower leg, and makes it possible to feel sensation in the back of your thigh, lower leg, even the soles of your feet.

When the sciatic nerve is compressed you may feel a burning sensation and pain. If the nerve is pinched, you may also feel numbness and weakness in your leg because the nerve signal has been interrupted. In some cases, sciatica may be caused by a tumor or cyst that is pressing on the nerve or nerve roots.

Disc damage

Sharp low back pain from herniated or ruptured discs can occur when the intervertebral discs become compressed and bulge outward—called herniation—or rupture.

When a disc herniates (or "slips"), all or part of it is forced through a weakened part of the disc, exerting pressure on surrounding nerves or the spinal cord. A disc can also rupture (or break open) from injury or strain.

Because they act as a cushion of sorts, intervertebral discs facilitate a full range of lower back movements, such as flexing, bending or twisting. But disc deterioration reduces that cushioning. Besides sharp low back pain, it can also cause some people to lose several inches of height.

Small tears (annular tears) that occur in the outer layer of the intervertebral disc can also cause acute low back pain. The pain can be severe, even if the amount of tissue damage is minor and it repairs itself quickly.

Lifestyle Risk Factors

Excess body weight, repetitive bending or twisting the lower back, lifting heavy objects the wrong way, sitting or standing for hours in the same position, and a generally sedentary lifestyle all increase your chances of experiencing sharp low back pain. Some research suggests that smoking may also cause sharp low back pain.

A Word From Verywell

Low back pain is one of the most common medical conditions in the United. Many times, if you have a sprain or strain, the pain will resolve itself. But by addressing your back pain, whether by seeing a doctor or making sure your daily life includes plenty of movement, you can help prevent sharp low back pain from turning into a lifelong condition.

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  1. 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

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