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Back Pain

Back pain can come on suddenly or gradually worsen over time until it becomes unbearable. Living with
acute back pain can be a debilitating experience. Back pain can feel like muscle aches, sharp stabbing pain, stiffness, lack of mobility, or a chronic ache after prolonged sitting or standing.

Causes of Back Pain

Back pain is NOT always age-related or a result of injury, and it isn’t always easy to pinpoint the cause of chronic back pain, so you should talk to a back-pain specialist if you're experiencing symptoms. The MOST COMMON cause of back pain is mechanical in nature and may include stress on the spinal structures including muscles, tendons, ligaments, intervertebral discs, spinal nerves or facet joints. This is usually due to weakness of the lower back which leads to excessive strain on these structures.

Other causes of back pain that are MUCH less likely, but still need to be screened out by a professional, would include:

  • Inflammatory; ankylosing spondylitis or sacroiliitis.

  • Oncologic: marrow cancer or nerve compression.

  • Infectious: spine infections

Other diagnoses that are commonly talked about in the lower back, but DO NOT necessarily cause pain, would include the following:

  • spinal stenosis, joint osteoarthritis, and degenerative disc disease.


This last group of diagnoses are more like buzzwords.  And negative ones at that.  When a patient is given these diagnoses, it does nothing except strike fear into their mind about their back being fragile, or “unfixable”.  This leads to fear-avoidance behaviors such as fear of movement (kinesophobia), fear of lifting weights, and fear of exercise in general.  It goes without saying, this can be detrimental to someone’s overall health and well-being. 


These findings are part of the NORMAL aging process and should not even be discussed when it comes to back pain.  I like to think of these findings as wrinkles or gray hairs on the inside of your body.  You wouldn’t tell someone with wrinkles on their face that they have “Degenerative Face Disease” would you?  Of course not!  In the same way we should not lump people with back pain into these categories and assume this is why they’re in pain.  The medical research simply does not support it. (More on that later!)


Yes, back pain can be incredibly distracting and painful, preventing you from performing and enjoying everyday tasks and activities. It can be disabling and interfere with your daily life, causing a significant loss of productivity if you’re working, but it doesn’t have to be that way!

How Fortitude & Freedom Can Help
Relieve Your Back Pain

My name is Dr. Jake Pawol, PT, DPT, OCS.  I’m a Doctor of Physical Therapy and Owner of Fortitude & Freedom.  I am a back-pain treatment specialist right here in Des Moines and can help you determine the best course of action and develop a custom treatment plan that addresses your specific back problems, alleviates your pain, improves your function and quality of life, reduces dependence on medication, injections and surgery, and treats you as a whole person.

Your custom treatment plan may include the following:

  • Thorough evaluation and movement analysis

  • Manual therapy, regenerative dry needling, joint and soft tissue mobilization

  • Exercise-based correction of underlying root causes of pain.

  • Improving strength and mobility which will make you more resistant to injury in the future

  • Keep you moving and exercising throughout your plan of care with customized exercises tailored to your body and your injury

Back pain shouldn’t be something you have to learn to “live” with.  I will give you the right back pain care to ensure you live a high-performance, pain-free life.  Because life is too short to avoid doing the activities you love with the people you love!

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