♪ Bob and Brad ♪
♪ the two most famous ♪
♪ physical therapists ♪
♪ on the internet ♪
- Hi, I'm Bob Schrupp, physical therapist.
Brad Heineck, physical therapist.
- Together, we are the most famous physical therapists
on the internet.
- In our opinion, Bob.
- Okay.
- Of course.
- Brad, today, we're gonna talk about these,
you know, when is your neck or back serious enough
that you should see a doctor?
- Yeah, this is a important thing
to have an understanding of, because-
- Right.
- When it's time, it's time to go in.
- Right.
And I, first thing we wanna talk about Brad is
the nature of referred pain.
We call referred pain, it's like,
let's say you're having trouble in your neck,
but it's sending pain down into your arm.
- Right.
- It's referring pain into your arm.
So quite often the further the pain goes down,
the more serious it's getting.
- Exactly.
- So a common pain pattern would be,
do you wanna turn around Brad?
- You bet.
- You're gonna start getting it in your neck.
Then you might get it between the shoulder blades.
And that can be from your neck, by the way.
- Sure.
- Or it can be in the shoulder blade
and then it can start to you know,
transfer down into your arm.
- Yep.
- So you go, you know, the outside of the arm,
sometimes on the inside of the armpit.
- Yep.
- And then it goes down the arm
and when it goes all the way into the hand
or there's tingling.
- Yep, yeah.
And particularly, you know,
and this happens because that's for the nerves,
this is following the nervous system.
But if you start get tingling, numbness,
or if you start losing strength in your grip,
you for sure gotta get into the doctor.
- Yeah, exactly.
- When you can't hold a cup of coffee,
that's in the symptoms.
I tell people it's time to, you know, bypass therapy.
Let's get going.
- So if we're talking about the back,
you know, on the back, Brad, you wanna turn?
- Sure.
- You know, it's gonna start in the back.
Then often it goes down into the butt.
Actually, quite often Brad,
if it's down here and nowhere else
a lot of times it's coming from the midback.
- Sure, yeah.
- 'Cause the midback sends pain down into here,
but if you're getting pain, you know,
it starts here and it goes into the butt,
back of the leg, calf, foot,
again, the further it goes, the worse it's getting.
- Right.
- And that's when you want to go out
and start, you know, thinking about seeing a doctor.
So, second thing, Brad,
just as a general rule of thumb
if you're under 20 or over 50
and you're having pain for the first time-
- Hm.
- They generally recommend that you go in and see a doctor.
- Sure.
- Third, if it never stops and it's constant.
- Hm.
- And I mean, like even at night, you're feeling it
or you know, there's just no relief.
- Right.
- It's just-
- No matter which way you turn.
- Which position.
- Yeah.
- Something's not going on right there.
I mean-
- It means, it may not be a mechanical thing,
that maybe-
- Something, inflammation or infection.
- Right, yep.
You know, I don't wanna get
into the chemical part of it but-
- Just yeah, as a rule of thumb,
and generally you're gonna be seeing the doctor
'cause you're so uncomfortable.
- Right.
'Cause it just wouldn't go away.
But constant pain is not a good thing.
Well, the first thing Brad and I like to see
when we're treating someone is we find a position
that takes away the pain.
- Right.
- Then we have a good chance of treating it.
- Right.
- And a lot of times Brad,
if we can find a position that even makes it worse,
that's a good sign.
You know what I mean?
- Right.
- 'cause that means we can make it better.
- Right, you just, yeah.
You have to keep looking for the way
that does make it better.
Before we go much farther, Bob,
I think we should mention a lot of these people
have not seen our channel yet.
And aren't aware of what you know, we can do for 'em.
- Yeah, we do a lot of videos.
We provide, upload a video every day,
seven days a week.
We're the hardest working therapists on the internet.
Right Brad?
- Exactly.
- And we have a subscribe button right over there.
You're gonna wanna subscribe.
Videos on how to stay healthy, fit, pain free.
- From head to toe.
- Yep.
- Now Bob, with the pain down the leg
I think, I wanted to mention something,
a real common thing.
Not common, but can happen is the drop foot.
- Oh yeah.
- If you're walking,
you got the pain down the leg
and you find that your foot kind of slaps down.
- Called slapping
- Or your toe is dragging.
'cause you cannot lift your toe up.
If you can't walk on your heels like this
'cause one is too weak.
- Right.
I think Lonnie was just gonna show that.
Did we get it Lonnie or not?
Wanna show him again Brad?
- Oh, okay.
This is a very common test for doctors
and therapists.
"Can you walk like this," or-
- [Bob] And also on your toes.
- Or on your toes.
If you could do that on one foot
and the other one's not strong enough,
you got back pain,
pain down your leg.
I'm seeing a doctor quick.
- Yep, you are.
'Cause things are getting serious very quickly.
If you've had cancer in the past
or currently have cancer
and you start having pain,
you need to go into the doctor.
- Get it checked out.
It maybe nothing, and maybe it's not associated.
- Exactly, we're not trying to alarm you,
but you just gotta, you know,
you've gotta be a little extra careful
if you're dealing with something like that.
- Cover your bases.
- If you're on a steroid medication,
you also need to go and see a doctor
if you're having pain.
Especially steroids,
'cause a lot of times they take away the pain.
So that really makes me.
- They mask it, yes.
- Right.
If you are abusing drugs
and you're starting to have pain,
you want to go in.
This is just a general kind
of public service announcement, Brad.
- Hm.
- All right Brad, another one is if you've lost
a significant amount of weight
or if you've lost weight and you're not trying.
- Right.
- Yeah, that's not good.
- Right.
- And there's something going on.
- Exactly right.
- and when you have pain with it.
- You need to get it checked out.
- Yep.
- I can't tell you how many times I've seen
that in people.
And sometimes it's been serious
and sometimes it's not, but-
- Right.
- You need to go in and check it out, so.
If you have a fever along with it, Brad-
- Hm.
- Especially I think about encephalopathy
or you know, some of those things that could happen-
- Sure.
- In the neck, you have a stiff neck
and you're getting a headache
or anything like that.
You're definitely gonna want to get it checked out.
- Right, it's not going away, getting worse.
- Right, that kind of thing.
- If you don't feel well, Brad,
and you're having pain along with it.
It's, I know that seems, you know,
that people would, "I know that I need to go in."
No.
A lot of people are like, "Oh, I just don't feel well."
But if you don't feel well
and you don't have pain, and you're having pain.
- You gotta take this into context.
I mean, if you've been around 30, 40, 50 years
you pretty much know what the common flu is like.
- Yeah, you know what your body is doing.
- You know, the common cold, those kind of things.
But you're having something that just is different.
And you're having these symptoms combined.
- I know when we have people on therapy, Brad,
and they're not getting better,
what do we do?
We send 'em back to the doctor, don't we?
- Yeah, we, these are our,
we call 'em red flags.
If a red flag comes up,
things aren't adding up,
you know, it's time to go in
and see if there's something else wrong.
- If you've had neck or back pain
for more than four to six weeks,
and you haven't seen anybody, you know,
it's time to go in too, and see what's going on.
- Right, you know, and if you see,
if you know you're gonna, it depends what country.
And a lot of times,
if you have direct access you can go
to see the therapist first.
Your therapist is gonna screen.
And if they're not, if they're concerned,
you know, they'll send you to the doctor
or go directly to the doctor.
- Right.
Did we talk about night pain, Brad?
We mentioned it didn't we?
- I don't think we did.
- Yeah, night pain is always kind of a red flag.
They always call it night sweats too.
- Right.
Say you got back pain,
but throughout the day, it's just fine.
And then you go to sleep
and it wakes you up at night.
And then you get up the next day.
Fine during the day,
let's say you have a physical job.
No problem at work.
No problem at home.
You go to bed.
It wakes you up in the middle of the night consistently.
Get it checked out.
- Yeah, that's always a little bit of a,
like you said, red flag.
- Yep, maybe nothing.
- Maybe nothing, but it's one of those things.
Yeah.
It's not typical.
'Cause generally when you're laying down
there's less stress on your back and neck
unless you have a really bad, you know, mattress.
- Sure, so.
(Brad laughs)
- All right, if you're having really severe pain,
and that I think most people know
they're gonna go in with that.
- Right, yeah.
- Something that you alluded to earlier Brad is
if you're starting to get some weakness,
now, you talked about drop foot.
Well, in the hand, let's say you're starting
to get a little weakness in your hand.
- Yep.
- Or weakness in the thumb
or weakness anywhere.
Numbness and tingling going all the way down.
It's time to go in.
- Right.
- When it gets that point, it's getting severe.
- Right.
- So, and then, you know, the big red flag
and you know, is if you lose control of your bowel movement.
- Right.
- If that happens, you're going to the emergency room.
- Yeah, if you're, and in that instance
we're talking generally about back pain,
or bowel or bladder.
The other thing with that Brad, is
if you have what we call saddle anesthesia.
If you have numbness
or tingling in the parts of your body where,
that would hit, if you're sitting on a saddle.
- Right.
- So, if I'm sitting on a horse on a saddle,
you know, all this area here
and that part, you get a sudden onset of,
what we call numbness or tingling,
plus you lose your bowel or bladder.
That's an emergency.
- Right.
- That means you've got a blown out disc.
- Right.
- And you need to get in immediately
to see a doctor.
- Exactly.
- That's not one you're gonna mess around.
- Yeah, you're not gonna make an appointment for,
you're going to the ER.
- Get on your horse.
(Bob and Brad laugh)
- We shouldn't joke on that one.
- Yeah, we shouldn't,
'cause that really is serious.
We talked about the numbness and tingling.
If things are suddenly getting very, very stiff,
the back or the neck,
you should also see the doctor.
There's a lot of, some kind
of disease processes that can cause that.
- Sure.
- So you wanna make sure
that you're getting in to see that.
An additional neck one Brad is
if you are getting pain in a lot of different,
like if you get pain in the front of the arm
and the back of the arm, different,
what we call dermatomes.
- Right.
- That's often a kind of a weird thing.
Generally back pain tends to run
what we call down certain dermatomes.
And so if you're getting the whole entire arm hurts,
that's really strange.
- All the fingers.
It's not just this pinky
and the half of this one or these three.
It's the whole hand,
the whole arm.
That's, yeah, like I said, this is not common
with the radiculopathy we work with.
- Right, if you got a fever
and you're vomiting and you have pain too.
You know, again,
I'm sure these are pretty common sense, but-
- Yeah.
- You know, sometimes people,
maybe they need a little extra incentive to go in
that, you know, if those things are happening,
you definitely need to go see the doctor.
- Sure.
- All right.
And you know, if you're not,
if things are going fairly,
you gotta watch some of our videos
because we provide lots of help,
hints on how to deal
with back pain and everything.
- Right, and if you got through this whole video
and you're still here,
you probably need to go in.
- All right.
Thanks for watching.
- Take care.