Why Do You Have a Shooting Pain in Your Lower Back?

Key takeaways:

• If you experience sharp, shooting pain in your lower back, it may be due to muscle strain or spasms.
• In some cases, sharp and shooting pain is due to a more serious or chronic condition, such as spinal stenosis, sacroiliac joint disease, and kidney stones.
• Short-term relief for sharp, shooting pain in your lower back includes treatments such as rest, ice, and stretching.
• Long-term relief includes treatment such as physical therapy, chiropractic, injections, and surgery.

Sometimes, a sharp, shooting pain in your lower back can become a very scary situation. Even worse, you may have pain radiating down one or both of your legs. But don’t be too scared just yet. We’ll explain why you may have these symptoms and what you can do in the long and short term. We’ll even let you know when you do need to see your doctor or go to the emergency room (ER). This article will review the issue and what to do about it.

Causes of sharp, shooting pain in your lower back

There are numerous potential causes of sharp, shooting pain in the lower back, some of which are more serious than others. Let’s take a closer look.

Muscle strain

The muscles in the lower back can become strained with excessive stretching or force. When the strain places pressure on the lower back nerves, a sharp, shooting pain in your lower back can result.

Spinal stenosis

Spinal stenosis is a narrowing of the canal where the spinal cord is present. Spinal stenosis can be caused by diseases like arthritis, aging, or bone spurs. Pressure on the spinal cord can lead to a sharp, shooting pain in your lower back.

Sacroiliac joint disease

The sacroiliac (SI) joint is where the sacral bone, a triangular bone at the base of the spine, joins the iliac bone, the largest and highest bone on both sides of the pelvis. An injury to this area can contribute to pain in your lower back.

Muscle spasm

A muscle spasm is an involuntary, painful contraction of a muscle with severe muscle tightening. It’s also been referred to as a muscle cramp or a “charley horse.” A muscle spasm can happen due to lifting something too heavy, extending or flexing the back too much, overuse, dehydration, standing with poor posture, or an odd sleeping position.

Abdominal aortic aneurysm

This is the most serious issue associated with severe lower back pain. It is also accompanied by abdominal pain and is a medical emergency. It occurs when there is a bulge in the wall of the aorta (largest blood vessel in the body), which could burst.

Other causes of sharp, shooting pain in your lower back based on another condition, symptom, or situation

You can have pain in your lower back on your left side or right side. Other symptoms – including where the pain is worst or where it spreads to – can clue you into what might be causing your symptoms.

Sharp, shooting pain in lower left back

A pain in the left lower back could be caused by a kidney stone, which could also cause pain in the right lower back. On rare occasions, a kidney stone can cause pain on both sides of the lower back.

Sharp, shooting pain in lower right back

In addition to all the reasons listed above, sharp shooting pain in the right lower back can also be caused by an injury due to a motor vehicle accident, sports injury, or work-related injury.

Sharp, shooting pain that’s shooting down both legs

A sharp shooting pain down both legs can be caused by sciatica, which is a condition that exists when you have pressure or damage to the sciatic nerve.

There are two sciatic nerves, one on each side of the body, that run from the lower back through the buttocks and hips and down the leg. To have sharp, shooting pain that’s shooting down both legs you would need a condition that places pressure on and compresses both sciatic nerves. Examples include:

• Muscle tightness, like piriformis syndrome (tightness at a buttock area muscle)
• Spinal stenosis
• Spondylolisthesis (a condition where a spinal vertebra slips out of place relative to another vertebra)
• A tumor
• Poor posture
• Obesity
• Wear and tear due to aging

Sharp pain in lower left back that’s shooting down your left leg

Sometimes, you can have a sharp pain in your left lower back that’s shooting down your left lower leg. The most likely cause of this is a muscle spasm and irritation of the left sciatic nerve. In addition, any of the other causes listed above may cause shooting pain down either leg.

Sharp pain in lower right back that’s shooting down your right leg

If you have sharp pain in the lower right back that’s shooting down your right leg, it can be caused by any of the same issues that cause shooting pain down your left leg. The issue just happens to be on the right side and affects the right sciatic nerve.

Diagnosing sharp, shooting pain in your lower back

There are several steps that a physician needs to take when a patient visits with sharp, shooting pain in the lower back, including:

• A thorough history
• Physical exam
• Initial imaging studies such as X-rays
• Further imaging studies, if needed, including computed tomography (CT) scan or magnetic resonance imaging (MRI)
• Laboratory tests for arthritis and some autoimmune conditions

An important note is that sometimes kidney stones are visible on X-rays, while other times, a CT scan is needed to visualize the kidney stone.

How to get short-term relief from sharp, shooting pain in your lower back

If you experience a sharp, shooting pain in your lower back, you have some options to obtain short-term relief, including immediate rest, ice, and stretching.

Rest

If you’re performing an activity and you feel sharp, shooting pain in your lower back, stop right away. Try to lay flat on your back with your knees flexed.

Ice

Apply ice to the lower back at the site of the pain and inflammation. If there’s tenderness right over a specific area of the spine, then try applying ice to that area. That can be especially helpful if the pain is due to SI joint disease.

Stretching

If the sharp, shooting pain in the lower back is due to muscle strain or spasm, then an immediate change in position and stretching could instantly relieve the pain.

Long-term treatment options for sharp, shooting pain in your lower back

For long-term treatment of sharp, shooting pain in the lower back, it’s important to treat the underlying cause and prevent reoccurrence. This can be done with physical therapy, chiropractic treatments, injections, or surgery.

Physical therapy

Physical therapy can be very helpful with certain conditions, especially muscle strain, spasms, and sciatica. If there are structural or postural issues, physical therapy can definitely help. Sometimes, there’s an ergonomic issue at work that needs to be addressed. Physical therapists can advise a home exercise program to prevent further problems.

Chiropractic

Chiropractic treatment can provide relief of muscular and spinal issues. It can be especially helpful for pinched nerves, which cause radiating pain down the legs.

Injections

Sometimes, a physician can inject the muscle, disc, or nerve to relieve the pain and symptoms.

Surgery

In some cases, surgery is needed, possibly including a procedure called a laminectomy, in which part of the spinal bone is removed to take pressure off the spinal cord.

When you should see a doctor about sharp, shooting pain in your lower back

You may need to see a doctor about your pain if symptoms persist. There are also cases when you should go directly to the emergency room (ER).

You should see a doctor if:

• The severe or shooting pain lasts more than 24 hours.
• You experience numbness or tingling in the lower extremities.
• You are unable to walk, move around, or perform activities of daily living.

You should go to the emergency room if:

• You experience any loss of bowel or bladder control.
• You have weakness in your lower extremities (legs).
• You have shooting pains down the back of your legs that don’t resolve after an hour or so.
• You also have abdominal pain associated with the sharp shooting pain in your lower back.

Questions to ask your doctor about sharp, shooting pain in your lower back

• Did you find anything on the physical exam, such as muscle spasms?
• What are your initial thoughts on diagnoses?
• Is it a kidney stone, or do you believe it’s something musculoskeletal?
• Should we get X-rays or a CT scan?

Frequently asked questions: sharp, shooting pain in your lower back

Here are some frequently asked questions related to sharp, shooting pain in your lower back.

How can you prevent sharp, shooting pain in your lower back?

The best way to prevent sharp, shooting pain in your lower back is to keep yourself healthy by maintaining good posture, not overexerting yourself, eating well, and exercising regularly. At the first signs of lower back pain, stop what you’re doing so you can rest, apply ice, and stretch.

What if you have the sharp, shooting pain in your lower back when bending over?

If you are bending over and you get a sharp, shooting pain in your lower back, it is probably from a muscle strain. It could also be from a disc issue or spinal stenosis, but this is not as likely as a muscular strain. When this situation occurs, try to stand up straight, get some rest, and apply ice if available.

What if you have sharp, shooting pain in your lower back and you are unable to walk?

If you have sharp, shooting pain in your lower back and are unable to walk, try to stand still and consciously relax the back muscles. If that doesn’t work, sit down and see if that relieves the pain. The inability to walk could be from spasms in your lower back or an irritated sciatic nerve. Both of these conditions can resolve quickly once the muscle is no longer strained and the nerve irritation is gone.

Final Thoughts

Having sharp, shooting pains in your lower back can be a scary situation, especially if these symptoms are associated with pain shooting into the legs. However, if you know the causes, you can manage the condition with short-term and long-term treatments. Consult your doctor for pain that lasts more than a day or so or pain that’s so severe it disrupts daily life.

General Medicine follows a strict editorial process, including using real experts to write our articles, vetted primary sources, fact-checking, a secondary medical review, and updates as necessary. This article was medically reviewed and fact checked by Dr. Poushali Bhattacharjee, MD.

Sources

El Sayed, Moustafa, and Avery L. Callahan. “Mechanical Back Strain.” StatPearls, StatPearls Publishing, 2024. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK542314/.

Casiano, Vincent E., et al. “Back Pain.” StatPearls, StatPearls Publishing, 2024. PubMed, http://www.ncbi.nlm.nih.gov/books/NBK538173/.

Wyngaarden, Joshua J. Van, et al. “Abdominal Aortic Aneurysm in a Patient With Low Back Pain.” Journal of Orthopaedic & Sports Physical Therapy, July 2014. JOSPT, 1033 North Fairfax Street, Suite 304, Alexandria, VA 22134-1540, www.jospt.org, https://doi.org/10.2519/jospt.2014.4935.