(upbeat music)
♪ Bob and Brad, the two most famous ♪
♪ Physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist,
- We're the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- So, number one sign your sciatica is getting better
or getting worse and what to look for.
This is really important as you go
through this program to know,
am I getting better,
am I doing the right things,
or am I doing the wrong things and it's getting worse?
- Right.
- This video is part of a series of videos
on treatment of sciatica or back pain.
If you want the entire series, go to bobandbrad.com
and look for our series of programs
and you'll see one on sciatica or back pain,
because you might be using this just for back pain.
- Sure.
- This generally is we're talking about sciatica here.
- Right.
Pain, numbness, tingling,
any of those unusual symptoms that go down the leg,
and I've had patients that come in
and said, I don't think I'm getting any better,
and I talk to them about what we're gonna talk about,
and I'm smiling, cause that's like
I know you're getting better
even though you think you're not
because of this reason.
- Right, symptoms that we're looking for,
pain, numbness, tingling, weakness.
- Right.
- And burning.
- And I've had people describe it as like cold water
running down their leg.
- Changes in sensations. - Yep.
- You can get the weirdest sensation
when you get nerve pain. - Right.
- Nerve involvement, I should say.
- Sure.
- So these are two concepts I wanna talk about
is centralization and probably peripheralization.
But we'll explain.
We use tape on Brad to show
what we're trying to accomplish here.
- Right, so location of the symptoms is really critical
to note, and as a therapist,
I have a diagram, and I draw it out,
so I have a good memory.
Cause my memory's not so good anymore,
but on paper, it's good as can be.
- That's right.
- So we're gonna - The best memory
is not as good as pale ink?
(laughing)
Is that what I had?
All right, so right here.
Brad's gonna show it.
This all represents pain.
And I know they're not connected.
Usually they are.
You know, pain is connected,
but this will do a good representation.
So, back pain, if it's just in the back,
that's not as bad as pain that has also spread down
into the buttock.
- And just to be clear, cause we mention,
when Bob says pain,
he's referring to all the symptoms.
- Yeah. - Like it can be
the cold, the tingling, the numbness.
Technically you can say symptoms.
I don't know if we need to get that technical.
- Right.
The overall concept here is the more it spreads out,
the worse it's getting.
So if it's just right here in the back,
it's not as bad as if it's spread out into the buttock,
it's not as bad as if it's spread out
into the posterior thigh here,
to the calf, and we even got one onto the foot here.
- Which is not uncommon either.
- Yeah, so it can be connected all the way down like that.
The more it spreads out, the worse it's getting.
The more it starts to retreat
back into the back,
the better it's getting.
We call that centralization. - Right, right.
- So let's say, we do some treatments
and the first day, you feel it,
that's what we look generally for,
is the foot pain too, right?
- Right.
- Foot, tingling, numbness,
has it got any better?
Is it any different?
You go, yeah,
you know, it feels a little bit better.
So we take this off.
That's improved. - Right.
Like I would say,
and I've had people say, oh my back is bothering,
or it hurts more here,
then I'll say, what about your foot pain?
Oh, that's not there anymore.
All that stuff is gone.
And I'm starting to smile.
It's like, okay, now we're going in the right direction.
Even though you are not aware of it.
- And Brad makes a good point.
Sometimes this pain can even get a little bit worse,
but these are getting better.
Let's say the calf pain goes away,
but the back pain gets a slight bit worse.
Still a great sign.
We wanna get rid of that pain that's traveling down the leg
before we get rid of the pain in the back.
- [Brad] Right.
- Generally, it's the way to go.
So, you're gonna keep moving right up here.
And eventually it'll be into the back alone.
And that's where we can then make it go away.
- Right.
Now conversely, it's getting worse.
Let's say we're doing things and you started off
with pain just here and in the buttock,
and all of a sudden you start feeling pain
in the posterior thigh,
or the calf.
That means things are getting worse.
- [Brad] Right.
- The worse sign of all by the way is let's say
this pain goes away and gets better,
but this pain gets worse.
- [Brad] Right.
- We're going in the wrong direction, then.
I don't want this pain to go away,
and this pain gets worse.
- [Brad] Right.
- That means we're doing something wrong.
So very simple.
Let's get the pain retreating.
Let's get it out of the leg.
Let's get it out of the butt.
Purely into the back,
then it'll eventually go away, once we get it up into there.
- And we have a number of videos specifically showing.
They're specific, we call them directional exercises,
that are gonna help centralize it.
We just did one a little bit ago,
that's gonna be a part of this series,
and we're gonna have a complete set
of videos - Complete series.
- that are gonna help you get the pain to centralize
where it needs to be.
- Not only exercise, but even the way you handle yourself
throughout the day. - Right.
- You wanna avoid those pain makers
which we talked about.
- Yeah.
- The more you avoid the pain makers,
a lot of time,
the better the pain.
- Yeah, sometimes it's changing posture.
That's very common.
- Right, so check out the other videos.
- There you go.
- Thanks.
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