♪ Bob and Brad, the two most famous ♪
♪ Physical therapists, on the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- And we are the most famous physical therapists
on the internet.
- In our opinion,
of course, Bob. - In our humble opinion.
Today we're gonna give you some fast relief
for that back pain and spasms.
These are some of the stuff that we have found
have worked for our patients and we hope
we can pass them on to you.
- There you go, Bob. - Successfully!
- That's exactly right.
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- Say no more, let's get on with the--
- Let's get, start with the show.
- There you go.
Bob, as you and I know from back pain ourselves
as well as, you know, hundreds or thousands
of patients over the last 20 and 30 years for us,
the first thing you wanna do is get them comfortable
and see if you can relax the muscles
and get that pain to come down very quickly.
And posture is one of the key issues with it.
And the next thing, you could either apply
some heat to it or cold to it, depending on the situation.
- Yeah, the whole thing is, the reason a back pain,
a back is spasming, it's trying to splint
and support, so you don't bend the back.
- Right, it's a natural mechanism for the body
to protect itself.
- Yeah, and it's usually trying to protect itself
from going into a bad position.
So a lotta times if you put it into a good position,
a lotta times that's gonna calm it down.
- Sure, you bet.
So the first thing is, also with this
we're gonna talk about, briefly, if you have pain
going down the leg that's gonna change things.
For the most part we're talkin' about that pain
that's in the back, it's central in the back,
maybe in the buttock a little bit.
But if you got pain running down the leg
that puts it in a different category.
- That's more sciatica and you should probably
check out some of our sciatica videos.
- There you go.
So the first thing is, find a position that you can
get it to relax, and you can do this either
in a seated chair, depending on the chair,
or laying down, we're gonna cover all three
of those positions. - Sure.
- So if you're in a chair now, personally what I do
is I use a recliner and my recliner obviously reclines,
but I absolutely must have lumbar support,
because most furniture and recliners do not have
enough lumbar support right here.
- No, and you're sinking in and you're going
into that rounded out position and generally,
with most people, the rounded out position,
that slumped position-- - Yeah.
- Is the one that may be causing your pain.
So we wanna get you,
I'm gonna show 'em on here for this one.
- Oh, go ahead, Bob, show 'em the anatomy.
- Yeah, again, so the bones are the strongest,
this is the vertebrae, it's standing up just like Brad
right now, facing this way, and generally the back
is the strongest when you have a slight curve in,
slight curve out, slight curve in.
So the more you can get your spine in that position,
generally the better it's gonna be
and the less pain it's gonna have.
The bad position, generally, is this.
- Right.
You're slouched. - The slumped position.
So if you're in a recliner that's soft
and you're sinking in like this,
you're gonna be in that rounded out position.
You wanna be in that S-curve. - Right.
- And that's why you use a lumbar support.
And also by reclining you're actually taking
some of the weight off the spine.
- Right, yep, exactly.
So you can use a towel roll like this
for that lumbar support right in here.
You could use a throw pillow, I have a lot of my patients--
- [Bob] That's what I use, is a throw pillow all the time.
- If it's not too big, if the size is right.
Typically a head pillow gets too big.
But sometimes I've had people have success with those.
You know, you can purchase lumbar supports,
like this is a memory foam one.
But what I'm gonna say then, when you get that position
and you find the back pain is relieving,
then, depending on what you respond better to,
you may know already if you use a cold pack or a hot pack.
- You've been using, well, you use both, don't you, Brad?
- I do.
If I have a real severe back pain and it just happened
because I did something silly, like I was out workin'
too hard and bending and lifting and I knew
I shouldn't have been doin' it, then I'll use a cold pack.
But if I've just got tight muscles and they're spasming
and they just feel tight, then I'm gonna go to a hot pack.
- Sure. - Okay.
And when I do use hot packs, what I use is the Thermotex.
- Yeah, Thermotex is infrared heat.
- Right.
- Or infrared rays, I don't really get what you call 'em.
But the reason why we like the Thermotex,
and Brad and I both use this, I just have it in my chair
every night, especially when it's cold like this now,
27 below in my area, 29 below in your area this morning?
- Whatever, it's freezin' water pretty quick.
- I actually sat on mine this morning.
(Brad laughing) I did, I was, we're havin'
our floors done so I had to eat my cereal watchin' TV,
and I put the Thermotex on even for that little bit.
So you can actually even leave it on.
But the reason why we like the Thermotechs
over regular heat, I'm just gonna show you
this demonstration real quick.
Regular heat only penetrates a minimal amount here,
just like a millimeter or two.
- [Brad] And when he says regular heat,
that's a standard hot pack, a convection hot pack
technically and it just heats up by contact.
Infrared is sending out the infrared rays
that are like the sun puts out and it goes much deeper.
- It goes much deeper, two point three six?
- [Brad] Two point three six.
- Two point three six inches and so you can see,
that penetrates down and that's starting to get
into the spine. - Right.
- And into the joints of the spine.
- Right, the muscles in your back, you know,
you've got some fairly--
- Yeah, you've got some thick muscles.
- Right. - Bands of muscles.
So that's why we use that.
I should rap you on the knuckles
like the old nuns used to do.
- Bob, why, Bob?
Why, once again?
Anyways, seriously, take your hot pack,
whatever you're using, hot pack or cold pack,
and put it back and use that physically
as part of the lumbar support, so that is giving
the physical comfort and then you're adding the heat.
- So you have this and then you have the Thermotechs
over the top, or this and the cold pack over the top.
- Right, as a matter of fact I actually just use this
because it offers enough support.
- It's enough lumbar support for you?
- Right, yep. - Gotcha.
- And then I don't need to have the, there's the cold pack.
- The cushion.
- If you're using the cold pack you definitely
need a cold pack that doesn't freeze hard.
When it comes outta the freezer it needs to be pliable.
And do not put it directly on your skin,
make sure you have at least a layer of clothing.
- We actually have a video on how to make a cold pack.
- Yep. - Very inexpensive.
If you wanna just go look up Bob and Brad cold pack.
- Yep, and it's just, you know, rubbing alcohol,
and some freezer bags and some tap water.
This time of year when it was 29 below I don't even wanna
put this on my back right now, but I'm gonna.
(Bob laughing) I'm gonna sacrifice it
for the viewers, thank you for that million,
I'm gonna enjoy this cold pack right now.
- [Bob] There you go.
- There you go, now that's in the seated position.
Oftentimes people can find better relief laying down.
- [Bob] Right.
- So we're gonna show you a few tricks that we've
learned over the years.
Now in your bed.
- You can take pillows.
- Yeah, show 'em the pillow trick, Bob.
- You can show pillows and put 'em underneath the--
- Oh, I had that other pillow here for you.
- Yeah, you need quite a few, that's the thing.
- For my head, Bob, I want a pillow for my head. (laughing)
- Okay, there, there.
- Oh, there it goes.
So this will typically be better than nothing,
but we've found that this leg wedge does a tremendous job
of relieving pressure. - I can't tell you
how many times I've used this and people just love it.
- Yep.
- The other thing, this is totally off on a different story,
but tangent, I have a patient who's got lymphedema
in his legs and this just works so well to put his legs up
and then he does his ankle pumps like this.
- Yep, sure.
- Just pumps that fluid right outta there.
- I've had this work for knee pain, hip pain,
back pain, the whole works.
And then you take your hot pack, you know,
you put it under there first so you don't have to go
through this gyration, especially when you got a
a mic wire. - You're getting your
mic wire there. - You're probably not gonna
have a mic wire when you're at home.
And then your cold pack can go under there
or your hot pack.
- You wanna be a little careful if you're laying
on a hot pack because you can get burned.
- Sure. - Because you're compressing,
there's not as much blood flow there.
Thermotechs less likely, because of that radiant heat,
I mean that infrared heat, it just doesn't get as--
- Right, it's not as intense.
There's only one level, it's not like the convection
where you usually have three levels.
And if you fall asleep on this, you don't wanna
fall asleep on either--
- No, do not fall asleep on either one.
- They recommend 45 minutes on the infrared
because it goes much deeper.
On the convection, typically 20 to 30 minutes maximum.
- Right.
- Cold packs, you can fall asleep with a cold pack
because they just warm up.
- Yeah, they tend to warm up.
- Right, so it's not, you know, again,
not directly on your skin.
- Generally you wanna cold pack for about 20 minutes
anyway and by then it's warming up anyway.
- I have fallen asleep with a cold pack on.
- Have you? - Yep, and then,
in bed I've done it, I just take it out,
put it on the floor, the next morning
throw it in the freezer again.
It's just a cycle, Bob.
- Yeah.
- The world is a cycle, cyclical and--
- That's right, it's all learning how to manage
your back pain sometimes, especially if you got
kind of a chronic situation.
So the other point, Brad, you can actually try
layin' down, can I have the pillows--
- Oh yeah.
You know, I used to have success with laying
on my stomach, years ago, and then as my spondylolysis
progressed, it's the worst thing I could do.
- Yeah, would not be good for spondylolysis,
but for a lot of back issues this actually
is gonna feel good.
You can start with a couple pillows like this
and just lay down like this and then you can have
another pillow here. - Sure.
- And just work your way--
- I'm gonna put the cold pack on you--
- Oh, thanks. - So you get to
have some of that today.
- Oh, appreciate that, Brad.
(Brad laughing)
Oh, that wakes me up.
- There you go. - But eventually you can go,
work your way to the point where you take
maybe one pillow out.
And then, you know, lay like that for a bit.
And then you actually could take another pillow out
and lay like that and even on just regular old
typical back pain, after a while you might even
lay like this in the prone prop.
- Sure. - We call it.
And it starts moving the back into that arch position
and a lotta times that helps calm things down.
- And along with that you can put the hot pack,
just leave it on there while you're doing this,
as well as the, or the cold pack,
whichever you respond better to.
You know, that's a big question, Bob.
People say do I use heat or do I use cold?
And I've had people that don't respond well to cold
no matter what. - Right, exactly.
- And then-- - Especially if there's
arthritis in there, arthritis typically the cold
doesn't feel good.
- But one way or another, if it is acute,
really sore and tender to the touch,
where it's like, oh, feels like it's all swollen,
that's when I'm gonna say back off on the heat,
lean towards the cold.
- Yeah, especially for the first, like, 24 to 36 hours.
- Yep, right. - 'Cause there's swelling
in your back, just like if you injure a joint.
- Sure.
- You sprain your ankle, you can definitely get
swelling in your back too.
- There you go.
- All right, well I hope we covered it
and remember, Brad and I can fix just about anything.
- Except for--
- A broken heart.
- But we're workin' on that.
- Yep.
If you've ever, I ask you, d'you ever break a heart?
- Bah, Bob, how can you ask me those things?
This is, we don't do things
from the neck up here. - Thanks for watchin'.