Did you know that low back pain is one of the most common causes of disability in America and responsible for billions of dollars in lost productivity each year? Despite the prevalence of low back pain and the huge burden it imparts upon society, many are uncertain of and frustrated by the nature of their pain.

Patients are often told “you just overdid it” and “put some ice on it and take it easy for a few days”. If this sounds familiar and if you have been struggling with pain, despite seeing your doctor, read further as we demystify the most common causes of back pain.


Arthritis simply means inflammation within a joint. The back has a special type of joint, called the zygapophyseal, or facet, joints; these joints are in many ways similar to larger joints in the body like the knee or shoulder – they contain a lubricating fluid, cartilage, and a fibrous capsule, all to protect the joint from irritation.

Unfortunately, as we age and as our bones are put under increased strain, these protective structures can begin to break down and degrade. As the protective structures wear away, bone comes into contact with bone, and this rubbing creates inflammation and pain. This process can even lead to the formation of bone spurs that can pinch nerves and cause further pain.

Spinal Stenosis

Up to 500,000 people in the United States may suffer from spinal stenosis, making this one of the most common problems we encounter at Integrative Pain Specialists (IPS). In medical jargon, stenosis simply means narrowing. When you have narrowing in or around the spine, any impacted spinal nerve can become pinched, inflamed, irritated, and ultimately painful.

The spinal nerves in the low back come together to form the nerves that supply the legs; this is why a pinched nerve in your back can cause shooting pain that runs down the front, side, or back of the leg, and even into the foot. This can also lead to numbness, tingling, and weakness in the legs as the problem becomes more severe.

Trigger Points

Trigger points are bunches of tight muscle that can be very painful. Trigger points most commonly form when an unconditioned muscle is subjected to an increased workload – in other words, when you “overdo it”. This can occur anywhere in the body but is very common in the back as well.

Trigger points are very tender to touch and can sometimes refer pain elsewhere in the body when they are pressed. Trigger points may lay dormant for years and just feel like a painless knot of muscle, but when they are irritated, they can rear their ugly head and cause debilitating pain for a patient. 

Feel Better

At IPS, we offer a host of therapies and interventions to help you feel better. We treat arthritis, stenosis, trigger points, and more on a daily basis. During your first visit to Integrative Pain Specialists, one of our skilled clinicians will assess you by performing a physical exam. By using a number of special provocative tests and questioning you about the nature of your pain, we will be able to tell you what the most likely cause of your low back pain is.

Imaging, usually with MRI, CT, or X-Ray, can give further clues about the exact nature of your pain. Armed with this knowledge, we will create a personalized plan for you that may include medicines, supplements, physical therapy, bracing, and injections – our goal is to get you to feel better! 

If you have been left in the dark before and feel like nobody will listen to you or explain why you have pain, we can help. Make an appointment today to get the treatment you deserve so that you can start taking charge of your life again!

About the author

Daniel Feivor, PA-C

Daniel is a recent Physician Assistant graduate from Roanoke, VA and a member of the American Academy of Physician Assistants and the Virginia Academy of Physician Assistants. He completed his training in 2020 as one of the top students of his class at Radford University Carilion. His education consisted of a 12-month vigorous didactic workload and one year of clinical rotations across multiple medical disciplines. During this time, he developed a broad foundation of both medical and surgical knowledge and was recognized with several prestigious awards and scholarships.

Daniel took an interest in pain medicine during his clinical rotations, where he saw firsthand how devastating chronic pain can be and how treatment can lead to unsatisfactory outcomes. Daniel is excited to join Integrative Pain Specialists and, as a pain management PA, he is committed to providing excellent clinical care, ensuring that his patients’ needs are both understood and addressed to their satisfaction.