Most of us have been seized by a sharp pain in the low back area at some point. If this has happened to you, you may have wondered what caused it, what might make it feel better and if it was serious enough for you to get it checked.
It’s important to clarify the answers to these questions so that if you need treatment, you can get it in a timely way. Early diagnosis and treatment is key to avoiding a chronic back problem.
I spoke with Dr. Kathleen Fink, attending physician at the National Rehabilitation Hospital in Washington, D.C. She informed me that a sharp lower back pain is a symptom with many possible causes. She said getting to the bottom of the issue depends on a number of things, including the location of the pain, if you feel it in only in one place or in several, if it moves around, and what types of movements make it worse.
"Back pain is like a big black box, and your doctor has to figure out what’s inside with only a limited ability to really look inside,” Dr. Fink told me. “And there are many, many things that can cause it."
Dr. John Toerge, osteopath, professor of medicine at Georgetown University and Medical Director of the National Rehabilitation Hospital’s Musculoskeletal Institute says that sharp, piercing and/or knifelike 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 says. Resting often helps reduce the pain, as may the use of a back brace.
"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 a pinching in that area." Toerge says this is true of almost all joints, not just those of the spine.
Toerge and Fink agree that some of the most common causes of sharp low back pain include:
- Muscle Strain: Most of the time, sharp lower back pain is due to a muscle strain, says Dr. Fink. Along with the sharp pain, you may also experience other symptoms.
- Facet Joint Pain: Facet joint pain is often related to mechanical problems with the spine.
- Spinal Fracture: Toerge says that spinal fractures are about the sharpest and most irritating back pain people experience. This is because there’s a rich nerve supply inside the vertebrae, he says. Like facet joint pain, spinal fractures are related to mechanical disruptions in the spine.
- Spondylolysis and spondylolisthesis: These conditions generally do not themselves cause sharp low back pain, Toerge says. But with extensive damage or aggravation of the condition, they may affect facet joints or even produce a spinal fracture. That, in turn, may lead to sharp low back pain.
- Sacroiliac Joint Dysfunction: Sharp low back pain may or may not accompany sacroiliac dysfunction, says Toerge. Sometimes the pain is more dull in nature. Toerge says the type of sacroiliac pain you may experience is likely related to the extent of the damage to the joint.
- 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, there’s the potential for pain in these areas, Dr. Toerge says.
This list is just to give you an idea about what might cause your sharp low back pain. If you have this type of pain, consult your doctor for more definitive information and a diagnosis.
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.