Sudden back pain: It can develop for several reasons, expert explains

by Mayo Clinic

edited by Sadie Harley, reviewed by Andrew Zinin

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One minute you're reaching for an item on a shelf, picking up a child or simply getting out of bed. The next, a sudden stab of pain in your lower back leaves you wondering what just happened. Many people call it "throwing out" their back. The phrase generally describes low back pain that starts suddenly, says Dr. Min Yoo, a physical medicine and rehabilitation specialist at Mayo Clinic in Arizona who has subspecialty training in pain medicine.

The good news is that although the pain can be severe, most episodes of low back pain improve with time, gentle activity and simple at-home treatment.

Causes

One of the most common causes is muscle strain, which occurs when muscles are stretched or torn, Yoo says. Ligaments, the tough bands of tissue that stabilize the spine, can also be injured.

Other possible causes of low back pain include an irritated or herniated spinal disk, arthritis in the small joints of the spine or irritation of the sacroiliac joint, where the spine meets the pelvis. In rare cases, a fracture of one or more vertebrae may cause sudden back pain.

Because these conditions can cause similar symptoms, determining the exact cause of low back pain usually requires a medical history and physical examination. Imaging tests may be needed in some cases but aren't necessary for everyone.

Not everyone's back pain feels the same. Some people experience a sharp, stabbing pain. Others describe a dull ache, muscle tightness or pain that worsens with certain movements. The movements that make your pain worse sometimes can provide clues about the cause.

"If the pain is worse with bending your back forward, that could indicate there might be a disk issue, such as a disk herniation," Yoo says.

Pain that becomes worse when arching backward, on the other hand, may suggest irritation involving the facet joints, which are small joints between each bone in the spine.

Treatment

If your first instinct when low back pain strikes is to crawl into bed and stay there, think again.

"Relative rest is recommended. However, it doesn't mean bed rest, because bed rest doesn't always make things better," Yoo says. Instead, he recommends temporarily avoiding activities that make your pain worse but continuing to move gently as much as is comfortable. For example, if your symptoms began while playing a sport, take a break from that activity until your back begins to recover.

For most people, applying ice may help during the first few days because it helps reduce inflammation. After that, heat may feel more soothing. Yoo notes that people with certain medical conditions, such as multiple sclerosis, may need to avoid heat therapy.

Nonprescription pain relievers, such as acetaminophen, ibuprofen or naproxen sodium, may help. The best choice depends on your health history and other medications you take. You may be able to take these medications together or alternate them, but check with your health care team first, Yoo advises.

People with kidney disease, stomach ulcers, significant cardiovascular disease or liver disease should talk with their health care professional before taking these medications.

When sudden back pain is an emergency

Certain symptoms require immediate medical evaluation, Yoo says. Seek immediate medical care if you have sudden back pain with:

• Loss of bladder or bowel control. If you physically cannot control your bowel or bladder, it could indicate that there's severe compression or pressure on the nerves in your spine, which could lead to lasting damage, Yoo says.

• Severe weakness in both legs or numbness in the saddle area. This is the area of the buttocks and inner thighs that would contact a saddle while riding a horse. These symptoms may indicate severe compression of the spinal cord.

Back pain risk factors

Although sudden back pain can affect almost anyone, some people are more susceptible than others. One of the biggest risk factors, according to Yoo, is weakness in the muscles that support the spine.

People who regularly lift heavy objects or do physically demanding work also may be at higher risk, especially if they don't use proper lifting techniques.

Older adults face some additional concerns. Postmenopausal women with osteoporosis have a higher risk of compression fractures in the spine. For that reason, Yoo recommends seeking prompt medical evaluation if sudden, severe back pain develops.

While not every episode of back pain can be prevented, maintaining a strong, flexible core and using proper body mechanics can go a long way toward reducing the risk of future injuries.

Key medical concepts

Low Back PainStrainHerniated Disk

Clinical categories

PhysiatryOrthopedicsHealthy livingFitness & Physical activity Provided by Mayo Clinic Who's behind this story?

Sadie Harley

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Andrew Zinin

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