Needle-like pain, back stabbing pain, what is going on? If the stabbing pain is not accompanied by pressure pain, and the stabbing pain is more pronounced when moving in a certain position, or if the sharp pain is more pronounced, it may be caused by neuromuscular or skeletal problems, or problems in the spine itself. If the pain is sharp, occurs suddenly, and is accompanied by dyspnea, it is important to look for pleural or thoracic problems. If the stabbing pain is very sharp, even with a knife-like or tearing sensation, the problem of aortic coarctation should be excluded.