- ♪ Bob and Brad ♪
♪ the two most famous physical therapists on the internet. ♪
- Hi folks.
I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Together we're the most famous physical therapists
on the internet
- In our opinion, of course Bob.
- Now we have big heads.
So today we're gonna talk about top three signs
your back pain is actually coming
from facet joint syndrome.
What a mouthful that is.
- Facet joint syndrome.
- Let's talk about what facets are.
Okay. You have your back and the bones stack up
to make your back.
While at each level of the bone, the vertebrae on the back.
You wanna come on up here, Brad?
- I do.
- [Bob] You got your pen?
Lonnie, pretty good right there?
- [Brad] One thing I wanna say,
'cause we're going all over the world,
there are parts of the world
where they'll pronounce as facets.
- [Bob] Okay.
- [Brad] Not facets.
- [Bob] Fascinating.
- [Brad] No, seriously.
I know it's from Australia, those people may.
- [Bob] The facets there's one or facets are
on each side of the bony prominence here,
the spines process.
So they're like a joint.
- [Brad] Right.
- [Bob] And it's just like a knee joint.
- [Brad] It is a joint, yeah.
- [Bob] Yeah.
So you have two knee joints on every back joint, basically.
- [Brad] Now you're confusing me Bob.
- [Bob] Yeah.
- [Brad] Let's flex this so they can see how they,
like right here.
This probably never happens in your back where the facets.
- [Bob] Hopefully never happens that much.
- [Brad] Yeah. That much.
But you can see, here's articulating surface here,
where the bones rub together.
There's cartilage in there.
There's synovoial fluid.
And there's a capsule. Everything that makes it.
- [Bob] It goes around it.
- [Brad] Hm mm.
- [Bob] And the thing is this joint,
just like any other joint, can get arthritis.
- [Brad] Sure.
- And that's the problem. - Yep.
- [Bob] So you can see if you stand
and you jam those joints together,
that makes the arthritis feel worse.
This separates the joints and takes pressure off 'em
and you'll see in a minute, that's why we can diagnose this
by some of the tests we're doing.
- [Brad] Sure.
- [Bob] This all makes sense in a minute.
All right. So the first thing the signs is,
that it is facet joint syndrome is first off,
it's gonna be better sitting
because when you sit those joints separate a little bit,
they're not jamming together.
- Right.
- It's gonna be worse with walking, tends to be.
So if your back pain's worse with walking
and worse with standing just prolonged standing.
- Or are we gonna go into the?
- We'll do that next?
- Okay.
- 'Cause the thing, what also tends to be better,
is we have it called shopping cart syndrome.
You feel a lot better when you're leaning on a shopping cart
or leaning on something on a walker.
- Right.
- When you bend forward. - Yep
- Because again, the joints are being separated.
Now yeah, let's show the test spread.
- Okay.
- So, if you're getting the mechanics of this, you know
that this feels better typically,
but this feels worse
and the location of the pain is typically more pinpoint.
- Okay.
So if you go back like this, you can also go
off to that side and that even jams it even more.
- Right.
- So let's say you're having pain on the right side.
- Sure.
- If you go back into the right and that makes it worse.
(groans)
- Yeah.
We're starting to think that it might be the facet syndrome,
facet joint syndrome.
If it's over here, you go back.
And to that side, hurts here.
It may again be the facet joint syndrome.
- Now what about if you do this
and you get pain there, but it also runs down your leg?
- And that's number three,
the number three you think you're looking at.
These are the same things that you'll find
with spinal stenosis.
- Sure.
- With spinal stenosis, all the things we just talked about
will have the same result, except with spinal stenosis,
it's gonna go all the way down the leg.
- Right. You're pinching a nerve.
- Yep.
Sometimes it goes down both legs.
- Sure.
- But with this, it tends to be more pinpoint,
the location of the pain is gonna be localized.
And right here, I have a patient right now that has it.
- Okay.
- It just sticks right there.
- Sure.
- And the other thing, this is gonna happen mostly
in people who are older.
This is very unlikely to happen in the 20 year old.
- Right.
- And maybe even 30.
- Yeah.
- People who are starting to get pretty severe arthritis,
they're gonna be more likely.
- More common.
- And if you have arthritis in other joints,
you're more likely to have it in your back.
- Sure.
- So if you have bad arthritis in your knees
that may be facet joint syndrome.
- Sure.
- But happy days are here Brad,
because on the next video,
we're gonna actually gonna show you some exercises
you can do for facet joint syndrome.
And we're gonna make sure we're.
- Yeah we better get going.
'cause they're waiting for the next video.
- All right. Let's go.