♪ Bob and Brad ♪
♪ The two most famous physical therapists ♪
♪ On the internet ♪
- Hi folks, I'm Bob Schrupp, physical therapist.
- Brad Heineck, physical therapist.
- Here we are, the most famous physical therapists
on the internet.
- In our own opinion, of course, Bob.
- All right, today we're gonna talk
about back pain, sciatica.
When do you need to see a doctor immediately?
Now, we're gonna always recommend that you see a doctor
to diagnose your sciatica,
or at least a healthcare professional,
but these are the instances
when you need to see a doctor now.
- Right, it's very, this doesn't happen very often.
I've referred two people over 23 years,
but it's very critical that you know,
and we'll get into it shortly here.
- Yeah, this video, by the way,
is part of a video series of videos on sciatica.
If you want to see the entire series,
go to bobandbrad.com and look for video programs,
or video series on sciatica.
- Right, you'll find a button to click,
and it'll bring you in there.
- So, we're just gonna start going down the list here, Brad.
If the pain travels below the knee
and you haven't seen a doctor yet, I'd recommend it.
That's probably the least innocuous one,
but this is the one I'd still probably
go ahead and go for.
- Right, you can have some symptoms to the knee
from sacroiliac problems, but still.
- Arthritis could even sometimes.
- Right, even a hip can do that,
but either way, seeing a doctor's a good way
to get it cleared out.
- If you're having leg, foot, groin,
or rectal area numbness, or anesthesia, as we call it.
- You're talking about saddle.
- Saddle anesthesia, do you wanna explain
what saddle anesthesia is?
- Sure, so if you imagine yourself sitting on a saddle.
You know, maybe a lot of people haven't,
but, so the area that the saddle contacts,
and the groin area, and the gluteal cleft,
any of that area becomes numb, tingling,
that is an indication that the nerves
that are being impinged
and irritated is to the point where--
- They may die.
- Yeah, it's a red flag.
You've gotta get in, and actually at that point,
particularly if you're having bowel movement problems,
you need to go to the emergency room.
It's not just, you know, set an appointment and get in.
- This is not the next day, this is right now.
- Right, exactly.
- I treated a patient that became paralyzed from this,
lost some of the muscles in his lower body.
- So actually had the worst case scenario.
- Yeah, worst case scenario.
- I had a person, she had this, she went into the doctor.
Yeah, she was a tough one to get to go to the ER,
but she had it addressed, and it wasn't,
she didn't need surgery, but you can't get,
you have to go in.
- You don't know the difference.
All right, if you're having along with the pain,
fever, nausea, vomiting, stomach ache, sweating.
You know, these are not normal things
to have along with back pain, so there could be something
a little more worrisome.
And so we wanna make sure you have it checked out.
- Right, you could have an associated infection
that you can just be treated easily,
but one way or another, back pain and fevers.
- Don't mix, they shouldn't go together.
- Right, it's not a mechanical back pain problem.
It needs attention.
- And as Brad already mentioned,
if you lose control of your bowel or bladder,
if you're losing control, that's time to go in fast.
- That's the emergency room run.
- If your legs are weak, especially
if you're getting foot drop.
Brad, do you wanna mention what foot drop is?
- Right, so if you're walking and if you can't pull
your toes up like that, and you don't even think
about it, when you walk normally,
your body just pulls the toes up.
If your foot's dragging, or it slaps,
and you're finding yourself compensating
with your gait with that slapping foot,
or it's dragging, and you've got the numbness,
the sciatica symptoms, you've gotta get in
to see a doctor, because a nerve is being so impinged
that it won't even allow your muscles to function.
That's later in the stages.
That's a severe stage of sciatica.
- Yeah, and again, it may not recover
if you don't get into it right away.
- Right, don't wait around and hope it's gonna get better.
- Yeah, if your pain was caused by an injury,
like from a car accident or a fall,
then you need to see the doctor right away.
Who knows what you might have, a displaced fracture,
or something that could really be causing problems.
If your back pain awakens you up at night,
kinda on a consistent basis,
it's always kinda a red flag.
You know, we're worried that, again,
there might be an infection or something that's,
because generally, when you're at rest,
a lot of times back pain gets better,
and if it actually gets worse,
that could be somewhat of a concern.
- So if during the day you're moving,
and generally it feels pretty good during the day,
but boy, about two o'clock in the morning,
it continually is aching, you gotta see a doctor
and get that checked out.
- If your back pain is not getting better
after two to three weeks,
let's say you haven't gone in at all,
I think it's a good time to see a doctor.
Maybe that's not an emergency, but it's one
that you should definitely get it on your list to do.
- Exactly, exactly.
- And finally, if a child or elderly person has back pain.
You know, we're always being
a little more cautious with that.
You know, child, it's unusual for them to have back pain,
and so we usually want to get them in fairly rapidly.
Or on an elderly person, there's just so many
other things it could be.
I mean, there's tumors and cancer.
I mean, I don't want to alarm you,
but there's all these other medical issues
that could be, and kind of--
- Right, and it might just be that their bones are brittle,
and they sat down too quickly,
and they had a compression fracture,
which is not a big deal, but it's very painful.
It will heal, but there are certain things
that make it heal better.
- But you wanna know it.
- Yeah, and with less pain that the doctor can point you
in the right direction.
- All right, thanks for watching.
Check out our next videos.
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