Brief Answer:
Stabbing knifelike sensation could be pinched nerve due to arthritis

Detailed Answer:
Good afternoon.

Sorry you're having these problems over the holiday season.

The fact that you've had such intermittent problems of 6 episodes over 3 years suggests that if this were some type of pinched nerve in the back that it would have to be specifically SENSITIVE to positional changes and that your condition may not be so egregious at this point as far as any arthritis in the back or similar to make this a nightly thing but that as time goes on this could become the case.

The other thing to consider would be something like a muscle cramp or sudden tightening of the bad muscles again which may be triggered by position or the way you are laying. Also, consider the quality of the mattress. It is recommended that both mattresses and box XXXXXXX be changed at least every 10 years for maximum comfort to the back. neck, and shoulders.

The only thing I'm not sure about in terms of muscle cramps is the very prolonged DURATION of your episodes. 20 minutes is an extraordinarily long time for a cramp to subside and usually something like sitting could actually make it worse as opposed to turning to one side or another and either curling up or extending the back which could cut the cramp off right away. Perhaps, if this were to happen again you can attempt to acquire one of these other positions and see what that does to the pain. If you find that a positional change really helps pretty consistently then, the concept of muscle cramp becomes more plausible.

However, for diagnostic purposes my first recommendation would be to obtain either a CT or MRI scan of the lower back to see exactly what the architecture of the spinal column is like and if there were any places where an obstruction or pinch could take place of a nerve or nerve root (most likely). If clear cut arthritic pathology is found in the exact area where you feel the most pain then, it would be up to your doctor how best to go about treating it or at least managing it if treatment were not possible entirely.

Blood work can also be obtained looking for things such as electrolytes and other blood elements routinely obtained in a good physical workup. It doesn't seem to me that you're the type of person who goes to doctors often and so my guess is that it's been awhile since you've had a good laboratory and physical checkup.

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This query has utilized a total of 15 minutes of professional time in research, review, and synthesis for the purpose of formulating a return statement.

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