Sharp Pain In The Lower Back: What Causes It
Sharp, stabbing lower back pain can turn walking and other daily activities into a chore. A sore back can lead to stiffness and restricted mobility, leaving people feeling uncomfortable for all or part of the day. As a result, lower back pain can affect overall health and well-being.
There are a few reasons why people get lower back pain. Therefore, it’s important to be aware of the “red flags” associated with lower back pain, and see a reputable experienced health provider for an accurate diagnosis before beginning any treatment. Our FYZICAL therapists in Mechanicsburg want to help those suffering from lower back pain get back their spinal health and return to normal everyday life.
Causes Of Sudden Lower Back Pain
Unfortunately, lower back pain is a common occurrence in the general population. In fact, as many as 8 out of 10 people will experience some form of lower back pain across their lifetime. Lower back pain can develop gradually over time, which is common with chronic conditions like arthritis or aging. However, in some cases, lower back pain may come on suddenly. Sudden lower back pain may be caused by different factors, including mechanical factors and medical conditions.
Here are some of the common causes of sudden lower back pain:
Muscle Strain
Muscle strain is one of the most common causes of mechanical lower back pain. It can occur from lifting heavy objects, twisting the back, or engaging in physical activities that strain the back muscles. Any slight movement that the spine is unprepared to handle may an episode trigger sharp, stabbing lower back pain. Symptoms can include difficulty walking, trouble bending or extending the spine, and pain with usually symptom-free activities like sitting or preparing a meal.
Joint Spasm
Joint spasm is another common cause of sudden lower back pain. It occurs when the muscles around the joints become tight and painful. This can happen to any joint in the back due to overuse, injury, or poor posture. However, when joint spasms occur, the culprit is often the facet joints. Facet joints are the small joints between the vertebrae (spinal bones) that articulate and allow the spine to move in all directions. As they are small and mobile, they are susceptible to injury, including spasms.
Herniated Disc
A herniated disc is another possible cause of sudden lower back pain. These can occur when the soft, cushion-like material between each vertebra bulges out. This puts pressure on the nerves exiting the spinal canal, and can cause symptoms like sharp, stabbing, or shooting pain. In severe cases, this can be associated with numbness or muscle weakness. Herniated discs usually require medical input.
Osteoarthritis
Arthritis is a degenerative condition of the joints. Whilst osteoarthritis is a chronic condition that develops gradually over time, acute episodes of lower back pain may still develop suddenly. In an area that is already likely deconditioned, it may take less activity or movement to trigger the pain. Acute episodes can lead to pain, stiffness, and reduced social or activity participation.
Sciatica
Sciatica is a type of lower back pain that occurs when the sciatic nerve, which runs from the lower back down through the legs to the feet, becomes irritated. This can cause sudden pain, numbness, and tingling in the lower back and legs.
Spinal Stenosis
Spinal stenosis is a condition that occurs when the space that nerves and other structures run through within the spine becomes narrowed, causing pressure on the nerves. Although stenosis usually develops over time, it can lead to sudden episodes of pain, numbness, and weakness in the lower back and legs.
Rare Causes Of Sudden Lower Back Pain
In addition, there are some rare causes of sudden lower back pain. These do not occur with great frequency, and usually, only develop under extenuating or specific circumstances. However, the following are a few of the rarer causes of lower back pain to be aware of:
- Kidney stones
- Fracture
- Tumour
- Infection
- Circulatory Problems
- Medical conditions, such as ankylosing spondylitis
Whilst most cases of sudden lower back pain can be attributed to a simple cause such as a muscle strain or joint spasm, some of the causes of lower back pain may need urgent medical attention. It’s therefore critical to be aware of the red flag signs and symptoms which may indicate something more serious is going on.
Red Flags Of Lower Back Pain
Red flags are the concerning signs and symptoms that may indicate the presence of a serious or potentially life-threatening condition. It is important to be aware of any red flags, as they can help healthcare providers identify the more sinister cause of any symptoms. Red flags usually require urgent medical attention for prompt investigation and treatment.
Red flag signs and symptoms associated with sharp, stabbing lower back pain can include:
- Chest pain or difficulty breathing
- Sudden or severe headaches
- Weakness or numbness in the limbs
- Loss of bladder or bowel control
- Sudden vision or hearing changes
- Severe abdominal pain
- Sudden dizziness or fainting
- Confusion or changes in behavior
- Unrelenting night pain
- Unusual bruising or bleeding
- Associated weight loss
Diagnosing Lower Back Pain
As there are many different causes of sudden lower back pain, a doctor should be consulted before commencing any treatment to confirm the diagnosis. Without an accurate diagnosis, a lot of unnecessary time and effort may be invested into the wrong treatment or, in some cases, the treatment may make the lower back pain worse.
There are several steps that a doctor takes to diagnose lower back pain. This includes:
- Medical history: A doctor will first ask a series of questions to learn more about the symptoms, mechanism of injury, and any aggravating or easing factors. This may include asking about any relevant medical history, particularly any back injuries or conditions, as well as occupation, lifestyle, and exercise regime.
- Physical examination: A doctor will also perform a physical examination to determine the cause of any symptoms. This will include an examination of the affected and surrounding area, checking for muscle strength, range of motion, and any abnormalities or signs of injury. They may also perform special tests that will rule in or rule out certain conditions, such as neural tension testing to check for nerve involvement.
- Imaging tests: Depending on the suspected cause of the lower back pain, a doctor may recommend imaging tests such as an x-ray, MRI, or CT scan to help diagnose the problem. Whilst this is not always necessary, particularly for mild or simple causes of lower back pain, imaging can be useful to identify any affected structures in the spine that may be causing the symptoms.
- Laboratory tests: In some cases, a doctor may order laboratory tests, such as blood or urine tests, to help diagnose the cause of the lower back pain. Although this may not be done for mild causes of lower back pain, it can be useful to rule out complex presentations of lower back pain.
- Specialist referral: If the doctor is unable to diagnose the cause of the lower back pain, they may refer one to a specialist. A specialist, such as a spine specialist or sports doctor, usually has advanced training and expertise in conditions related to the spine and associated injuries, and therefore may be able to assess the condition more thoroughly.
- Rule out any red flags: If the doctor establishes the presence of any red flags that are cause for concern, such as loss of bladder control or confusion, they will recommend immediate medical input from an urgent care team.
Treating Lower Back Pain
The treatment for lower back pain depends on the cause, severity, and duration of symptoms. Some cases of lower back pain may resolve with simple treatments such as relative rest, ice or heat therapy, and time. However, for more moderate or persistent cases, other interventions may be required.
Physical therapists are ideally positioned to treat lower back pain. They can assess the mechanical and musculoskeletal causes of pain, and identify any red flags that require onward referral. Where appropriate, physical therapists can prescribe exercises and other treatments, such as taping and massage, to address the underlying cause and alleviate any symptoms. Physical therapists may recommend lifestyle changes, such as increasing daily activity, commencing strength-based exercises, and reducing prolonged periods of sitting.
In some cases, lower back pain may need to be treated with medications, such as anti-inflammatories or opioids. A doctor can prescribe these medications as required, and may even recommend a corticosteroid injection to reduce inflammation. For severe cases of lower back pain, or for symptoms that are caused by trauma, a medical condition, or that haven’t responded to conservative (non-surgical) treatments, a doctor may recommend a review with a surgeon.
Lower Back Pain Doesn’t Have To Get In The Way
Lower back pain can be a frustrating and debilitating condition that can interfere with daily activities and quality of life. However, it's important to remember that lower back pain doesn't have to get in the way of living a healthy and active lifestyle. There are a variety of treatment options available, including medications, physical therapy, and lifestyle modifications, that can help reduce or eliminate lower back pain.
Speak to our team at FYZICAL Therapy & Balance Centers - Mechanicsburg to learn more about the ways to treat sharp, stabbing lower back pain.
References
Physiopedia. Low Back Pain. Available from: https://www.physio-pedia.com/Low_Back_Pain.
Health Gov. Prevent Back Pain. Available from: https://health.gov/myhealthfinder/healthy-living/safety/prevent-back-pain#take-action-tab.