What Can Cause Shooting Pain in the Lower Back?

Symptoms that may accompany shooting pain in the lower back may include:

• Pain radiating in the buttocks, hips, and down through the legs
• Numbness
• Tingling
• Weakness
• Incontinence

See a doctor if you have signs and symptoms along with lower back pain that may indicate serious conditions such as: 

• Abdominal aortic aneurysm
  • A rare, serious medical condition
  • Lower back pain that may also spread to the groin, pelvis, and/or legs
  • Severe, continuous, stabbing pain felt deep in the abdomen between the breastbone in the center of the chest and the belly button
  • A pulsating mass in the abdomen, which may be felt through the skin and is sensitive to touch.
  • Pain in back associated with a weakness or numbness of one or both legs
  • Sudden and rapid heartbeat, shallow breathing, clammy skin and cold sweats, general weakness, confusion, anxiety, and/or loss of consciousness, indicating shock
• Cauda equina syndrome
  • Can result in severe impairments in the lower back and leg(s)
  • Difficulty or inability to control bowel movements 
  • Urinary retention or incontinence 
  • Numbness in the groin, buttocks, genitals, and/or inner thighs (“saddle numbness”) 
  • Sexual dysfunction 
• Spinal tumor
  • Persistent pain even with rest and medication
  • Fever and chills
  • Night sweats
  • Progressive or sudden motor weakness in the leg(s)
  • Unexplained weight loss
• Spinal infection
  • Fever and chills
  • Pain worsens at night
  • Swelling, warmth, and redness around the site of infection
  • Unexplained weight loss
• Acute trauma
  • Leg pain and numbness
  • Inability to lift the foot (foot drop)
  • Complete loss of sensation in one or both legs indicating paralysis

The cause of shooting pain in the lower back is diagnosed with a patient history and physical examination of the back. The physical examination may also include range of motion tests to check mobility as well as a neurological examination to check muscle strength, skin sensation, reflexes, and cranial nerves.

Additional tests used to diagnose the cause of shooting pain in the lower back may include: 

• Imaging tests
  • X-ray
  • Computerized tomography (CT) scan 
  • Magnetic resonance imaging (MRI) scan
  • Bone scan
  • SPECT scan
  • DEXA scan (also called bone densitometry)
• Electrodiagnostic tests
  • Electromyography (EMG) 
  • Nerve conduction studies 
  • Somatosensory evoked potentials (SSEP) if spinal cord dysfunction is suspected
• Diagnostic injections to help pinpoint specific anatomical structures as the pain source

It is important to see a doctor for a diagnosis of the cause of shooting pain in the lower back in order to receive proper treatment. 

Home treatment to relieve shooting pain in the lower back may include:  

• Gentle stretching
• Bed rest for 1 to 2 days at most — activities should be resumed as soon as possible
• Cold and hot compresses 
• Over-the-counter (OTC) pain relievers to reduce pain and discomfort 
  • Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen (Aleve)
  • Acetaminophen (Tylenol)
  • Aspirin 
    • Do not give aspirin to children under 18 due to the risk of a serious illness called Reye’s syndrome
  • Topical capsaicin and lidocaine
• Physical therapy
• Acupuncture

Movement can be effective for relieving shooting pain in the lower back, and strengthening back, abdominal, and leg muscles may help prevent shooting lower back pain from recurring. Talk to your doctor or physical therapist before performing exercises for lower back pain. Depending on the cause of the lower back pain, some exercises may not be recommended.  If any exercises worsen the pain or cause new pain, stop and contact your doctor. 

If conservative home treatments and exercises are not effective in relieving shooting pain in the lower back, medical treatments may include: 

• Spinal manipulation and spinal mobilization such as chiropractic 
• Transcutaneous electrical nerve stimulation (TENS)
• Prescription medicines
  • Muscle relaxants
  • Opioids (for short-term use only) 
  • Anticonvulsants (may be helpful for sciatica)
  • Tricyclics and serotonin and norepinephrine reuptake inhibitor antidepressants (SNRIs)
• Spinal injections
• Implanted nerve stimulators 
• Surgery in severe cases