Sharp Lower Back Pain Causes and Diagnosis

Lower back Pain
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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 caused it and what you could have done to relieve it. Perhaps most important, though, you may have wanted to know if it was serious enough for you to get it checked.

It’s important to clarify the answers to these questions quickly. That way, if your sharp lower back pain does require medical treatment, you can start that in a timely way.

Otherwise, your acute, short term problem may evolve into a chronic condition. And early diagnosis and treatment is a key step for avoiding long term pain.

Sharp Pain in Your Lower Back

I spoke with Dr. Kathleen Fink, attending physician at the National Rehabilitation Hospital in Washington, D.C., who informed me that a sharp lower back pain is a symptom with a wide variety of possible causes. 

"Back pain is like a big black box. Your doctor is tasked with figuring out what’s inside with limited access to the contents," Fink comments. “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 in only in one place or in several, if it moves around, and what types of movements make it worse, she says.

Dr. John Toerge, osteopathic physician, 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 comments. 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 the 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 Dr. Toerge mentioned above. Facet joints are located at the back of the spine and help to keep the entire column on track. These joints can be the site of arthritis related conditions, or they may be injured in a car accident or similar trauma.

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 sets in, the facet joints (discussed above) may be affected; another possible outcome of excessive damage related to spondylolysis or spondylolisthesis is a spinal fracture (discussed below.) Any of these, in turn may lead to sharp low back pain.

Spinal Fracture

Another type of mechanical problem that can lead to sharp lower back pain is spinal fracture. In fact, according to Toerge, spinal fractures are about the sharpest and most irritating back pain people experience.

He explains that the reason for this is likely the rich nerve supply located inside.

Sacroiliac Joint Dysfunction

Sharp low back pain may or may not accompany sacroiliac dysfunction, says Toerge. Sometimes SI joint pain is more dull 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, 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 experience sharp low back pain be sure consult your doctor.


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.