How To Tell If You Have SI Joint Pain
Вставка
- Опубліковано 22 тра 2024
- When you're dealing with back, butt, or sciatica pain- it can be difficult to identify the cause (diagnosis). Let's boil everything down, so that you can determine with a HIGH degree of certainty whether or not your SI Joint is the cause of your pain.
Despite continued advancement in imaging- back problems remain the #1 most common cause of disability in the world.
Could it be a disc problem, facet joint issue, nerve problem, SI joint dysfunction?... all of these questions are something people constantly ask me about. SI joint pain specifically is something that many people are treated for, but are left confused about. With all the terms that are thrown around- inflare, outflare, nutation, counternutation, anterior pelvic rotation, posterior pelvic rotation, upslip, downslips, etc.... figuring out if the SI joint is the cause of your pain can feel like you're trying to solve a never ending puzzle.
So, in this video- I boil everything down, so that you can determine with a HIGH degree of certainty whether or not your SI joint is the cause of your lower back, butt, or leg pain. Buckle up for this in depth training, as here's some of what you'll learn:
- The difference between SI Joint Pain & SI Joint Dysfunction and why one cannot be defined
- All about SI joint diagnostics- boiled down in a way that makes sense…
- How experts determine if your SI joint is the most probable cause of your pain (with 78% accuracy no injection needed!)
-- The 3 elements of a sound clinical diagnosis (most docs miss at least 1)
-- The DIY diagnostic algorithm that allows you to pinpoint SI joint pain better than most orthopedic specialists
-- What you need to know: SI joint research you should be aware of
- How your diagnosis informs your treatment recommendations for relief
As you can see, instead of jumping right to injections to try and figure out the cause of your pain... it's possible to identify the most probably source of back pain without diagnostic tests and injections- saving you time, money, and pain that comes along with these options.
Let me know your thoughts about this video below in the comments.
Hope this is helpful for anyone trying self tests to diagnose sacroiliac (SI) joint pain.
00:00 - Intro
01:20 - Agenda
03:12 - The difference between SI Joint Pain & SI Joint Dysfunction
07:27 - How experts determine if your SI joint is the most probable cause of your pain
12:32 - The 3 elements of a sound clinical diagnosis
25:36 - How to rule out your back as the cause of your pain- Your repeated movement exam
36:16 - How to check the health of your nervous system- Neurological exam
41:39 - Your SI joint provocation self tests
53:07 - Your SI Joint DIY diagnostic flowchart
58:50 - How your diagnosis informs your treatment- Recommendations for relief
#drcharliejohnsonpt #sijoint #sacroiliacjoint #backpain #sciaticapain #sciatica
--
FREE DOWNLOAD 👉 "Better Than An MRI DIY Diagnostic Guide" - www.drcharliejohnsonpt.com/di...
FREE FACEBOOK GROUP 👉 The DIY Diagnostic Network - urlgeni.us/facebook/YUTB
FREE WORKSHOP 👉 Beat Butt Pain: The 4 Simple Secrets That Skyrocket Your Chances For Relief And Unlock Natural Healing Without Pills, Shots, Surgery, Or Needing Others To “Fix You” - www.drcharliejohnsonpt.com/fre...
APPLY TO WORK WITH ME ☎️ www.drcharliejohnsonpt.com/apply
Say Hello:
EMAIL 👉charliejohnsondpt@gmail.com
FACEBOOK 👉 / physical-therapy-johns...
INSTAGRAM 👉 / drcharliejohnsonpt
*Does your pain have you feeling trapped, alone, hopeless and on an emotional rollercoaster? It's not your fault and it's totally normal. In fact, many people I work with feel this way. You can visit www.curable.com/charliejohnsondpt to start a free 6 week trial of the CURABLE App. And yes, this is an affiliate link... but it's one I truly believe in and stand behind and have seen it help so many first hand.
*My Amazon Storefront: www.amazon.com/shop/dr.charli...
*Affiliate Disclaimer:
Note affiliate links allow you to find the items mentioned in this video or other helpful resources and support the channel at no cost to you. While this channel may earn minimal sums when the viewer uses the links, the viewer is in no way obligated to use these links. Thank you for your support!
-
• How To Tell If You Hav...
Thanks so much for watching! Want to pinpoint the source of your back, butt, or sciatica pain without needing expensive images or a specialist?🔥Grab my FREE “Better Than an MRI DIY Diagnostic Guide” here 👉 www.drcharliejohnsonpt.com/diyguide
Blows my mind that thousands of people watched this incredible vid and couldn't be arsed to press like! Come on people, this is amazing information. Thank you Dr. Cj!!!!
Agree
Thanks for watching 🤣🤣. Appreciate your support!
Dr Charlie
Fully agree with you . I believe if the program is divided into 5 to 6 parts with examples ( human cases) , definitely will be real hot cases to watch . I certainly learned a lot and am sure many with good understanding of human physiology will very much appreciate the wealth of knowledge shared here .
I hope this will be start of several parts with live demonstration that allow thousands of viewers watch and recommend the program to others. Thank you
I have had SI joint issues for about two years now, but doctors kept diagnosing me with a disc issue, even though my back MRI came back normal. I have the tingling in glute and sciatica symptoms. I have a unique case of falling a lot due to roller blading and I also have one leg that is weaker than the other due to knee injury over 8 years ago. So many doctors kept saying it's not my SI joint. Yet doing SI joint stabilazation exercises from my new PT are what has provided me the most relief. and one of my neurosurgeons said that my MRI showed an inflamed si joint. So don't knock out SI joint diagnose too quickly without asking enough questions. None of my doctors asked me if I had fallen or any sort of imbalance when walking. They just automatically assumed it was a disc or facet issue.
glad you're feeling a bit better! thx for watching
Ok so how do you fix it…?
Thank you for very well presented , described, explained the whole examination of pain and finding at comfort of home, the probable source or cause of the problem. The flow chart - 53 to 55 minutes- was very good self- diagnostic assessment . Thank you
Omg this video is amazing!!!!! I am waiting on my updated MRIs right now. This video allowed me to realize that it’s probably not my SI joint and probably my L5-s1 disc getting worse.
Awesome! Glad it could help you sort some things out. Let me know if you are interested in some help or get stuck!
Dr Charlie
@@drcharliejohnson i definitely will !
Amazing. Thank you.
Thank you SO MUCH for all your time giving me these tools. You are awesome!
You’re welcome!
Great overview! Thank you!
You’re welcome Joan! Let me know if you have questions or get stuck
Hey mate great evaluations regarding diagnosing lower back pain and excluding area's. Could you do one on Tension headaches. And the diagnostic evaluation why the occipital nerve, trapezius, lavator scap, posture, autonomic nervous system and other possible causes could be preventing it from improving
This was very very useful
Thank you for the information. Well presented.
Glad it was helpful!
Thank you for sharing the video. Great information.
Welcome! Glad it was helpful!
Great flow chart.Helpful
Glad it was helpful!
Thank you very much for the information.
I'm suffering from left hip area pains and was told to have a hip replacement.
After watching your video I understand it better and will do to the self diagnosis test to confirm it is a Sl joint fracture... Vinaka Vakalevu from Fiji
Im 3 minutes in and I’m so excited to learn this thanks for this!!
Very informative. Thank you
You’re welcome! Glad I could help 👍
Let me know if ya have specific questions or are interested in some help.
Again, extremely useful information. Thank you.
Welcome!
Very effective. Thanks for your quality approach!
You're welcome! Thanks for watching- appreciate the feedback and glad it was helpful!
My pain is gone thank any 🙏🙏🙏 but still curious about the root cause. One former PT said Gluteus Minimus and the other said too shallow/ fast breathing. Still think those were effects not the cause. Root cause was probably combo of tight Psoas and hips. And it caused pain in right glute and lower back area/ pelvic area. But who knows!? Really appreciate how you thoroughly diagnose anyone coming to you for help. That alone is so incredibly valuable. Being validated like that 🫶
Amazing presentation, thank you! Love the algorithm/process scheme, such a good way to explain a complex topic.
Glad it was helpful!
Thank you Dr Charlie u have given me peace of mind .I have an angry sciatica ,now that u have explained the differences. When I sit or go to bed it acts up ,I now sleep higher up on two pillows that really helps and I use an extra cushion while I sit .your presentation is better than going to a doctor or specialists.As I have gone down that road also .I will be using my common sense from now on and listening to your fantastic videos you are amazing ❤
This was the most comprehensive explanation of what occurs when I visit and revisit and revisit my Ortho. I have been diagnosed with many things over the past 10-15 years, but I want to know which one of my issues is causing me the most pain. I have recently been suspecting si joint pain, but my orthos disagree. They suspect facet. I appreciate the full and thorough explanation, as you have provided here, instead of the standard "just trust me, I am the Dr" or short confusing explanations as I have always received in my Ortho appointments. I will be performing my self assessment as you have outlined asap.
Hey! Thanks for watching. Appreciate you sharing your story.
Let me know how your self evaluation goes.
No pressure, but if you’re interested in some help- I’d be happy to review your case and see if/how I may be able to help you.
Just let me know.
Hang in there!
Dr Charlie
I’ve been into 2 head-on car wrecks and when I was stepping off my boat my broken leg went out from under me and I flew into a stainless steel gas pump and I even dented it so I shattered my arm spiral break shattered the both balls broke my collarbone my neck that I was a mess the doctor said I couldn’t put me back together 😥
I just had to heal sleeping sitting up in the sling 😳 but I know you know what you’re looking for regular doctors they do not … and I thank you for all the work you do God bless you my dear🫡. 🕊🇺🇸🕊
Thank you Dr. I have intense lower back pain. Al the expensive tests and medications brought minimum relief. I'm going to try your recommendations.
Elmari from South Africa
God Bless You Charlie 🙏. 🕊🤍🕊
Thank you🎉
You’re welcome 😊
First of, a huge thank you for all you do! You rock 🤩 After watching loads of other youtube videos I came across your channel and have watched quite a few of your videos but still not quite sure "what's up" with me....I have no pain in the back but a very clear pain in the left SI joint and left buttock but also pain in my left ankle (on the outside). It's painful to roll over in bed and to ut my socks on but again, that pain in my left ankle confuses me! Can you shed even more light on this? Thanks again ☺
Hey! Thanks for watching 👍 and sharing. Honestly, tough to say if and/or to what extent the ankle pain is linked. Does moving your back reproduce the ankle pain (make it worse/better). Not having back pain doesn’t necessarily mean it’s not a lower back issue.
So, could be several things and I’d need some more details here.
No pressure, but would you be interested in submitting details of your specific case so that I can personally review?
If so- just visit www.drcharliejohnsonpt.com/apply - select a time to chat and follow instructions to submit a Case Review 👍
Hang in there!
Dr Charlie
PS- Merry Christmas! 🎄
Thanks!
Thank you!!
@@drcharliejohnson should be required class for PTs.
@@alicialabrecque7927 👊🏼 maybe one day I’ll create a course for clinicians. One day at a time 👍. Thanks for watching.
Curious if I can ask- are you a PT/provider or a person in pain?
Thank you so much for your incredibly comprehensive look at where my pain is originating. This has been the most helpful and informative video that I’ve seen and I’ve seen many! I think my pain is from piriformis syndrome. I will visit my local physiotherapist to confirm it.
Hey Brenda! Thanks a million for your feedback. Glad I could help.
No pressure, but would you be interested in having me review your case personally to see if/how I can help?
If so, just visit www.drcharliejohnsonpt.com/apply - select a time to chat and then follow instructions to submit a formal case review.
If, after reviewing your case, I don’t feel 100% confident I can help- I’ll just let ya know.
Okay?
Let me know either way.
Thanks Brenda!
Dr Charlie
@@drcharliejohnson Wow, that would be amazing. I've been doing the exercise you said to shorten the muscle and it's only one day but there's definitely relief. Thank you so much. I'll apply online 😊
@@brendagouws659 awesome Brenda! Sounds good! Look forward to reviewing your case. I’ll keep an eye out 👍
idk but the casket at 7:00 is where I feel like jumping and keeping one foot up -mit as well die the way I feel . I feel like my left is side shorter than my right....... I sit here as I take. a puff of medical smoke ,brings me relief. for me its is and heel. ty so much its very very informative. really helped me a lot man . I swear I have si for sure low left is if I push in and hold it I feel so good like its about to heal but if I hold it and walk all good.alll in my heel left back and heel so bad. ps I watched this for 4 hours 3 times lol.
I have terrible pain in my lower back compression ? Thanks
I have been learning so much watching your videos. I have been trying to self diagnose a 2 month health period from hell. I’m a server and as is common in the industry, don’t have health insurance. I have spent thousands out of pocket to get help and still have no answers. It started as a severe bladder infection (or what I thought was) I had cloudy urine, foul smell, etc. went to two different doctors who sent my urine off to be cultured. Both times it came back that I had blood in the urine but no bacteria. First Dr diagnosed me as having acute interstitial cystitis. Second Dr diagnosed as SI joint dysfunction when she saw I could not lift either legs from a lying down position. Problem is I had insane tingling numbness and I could not stand up or lift my legs. I haven’t slept well in months because my pelvic floor is hypertonic and abdominal muscles are clenched all night long (it has traveled now to my quads. They are rock hard and muscular from being contracted all night). I def am experinecing pelvic floor dysfunction and the pelvis is holding on to emotional trauma but meditation, supplements, stretching, etc. is not helping. In the beginning my inner groin was super tight like a rubber band about to snap. My pelvis too feels like the ligaments are pulling. If I go to the gym and do gentle stretches, my pelvis and vulva swell up and are on fire for 2-4 days. I don’t feel like I have bladder pain, urgency, any of the common uti symptoms but I do feel a little relief in my pelvis if I take AZO pain relief tablets. Other times it seems more exoskeletal. If anyone has any ideas, please point me in the right direction because I’m desperate for help. Right now my best guess was a pendendal nerve issue?
I know it’s SOOO difficult!!!Look up pain free you.. or Dr. Sarno. I have had similar and I have had to stay away from diagnosis. Trying to figure it out made it worse. You’re right about the psychological trauma.
Hey! Wow- thanks for sharing but sorry to hear…
Honestly, not sure even if I can help, yet..
Would you be open to submitting specific details of your case and setting up a time to chat so I can confirm either way?
If so- just visit www.drcharliejohnsonpt.com/apply and find a time that works.
If, after reviewing your case, I don’t feel 100% confident I can help- I’ll just let ya know.
Okay?
Hang in there!
As a person that's had Interstitial cystitis for years. That doesn't sound like that's your problem. Your problem really sounds awful. I really hope you get a correct diagnosis soon.
@@anitadehart3000 I do believe I had a combination of a tight/compressed piriformis that combined with a tight psoas muscle and severe constipation just caused a domino effect of pelvic/back issues. My pelvic pain is so much better and no more uti symptoms. One of the scariest, most painful times of my life and now I have so much compassion for anyone suffering with IC
@@drcharliejohnson he doc, so sorry I never got notified of your comment. I am doing much much better now thank god. I so appreciate you offering to speak to me. It means a lot.
You help me
10 yrs of pain they say SI joint hmmm dont think so worse sciatica pain ever how it's started now hips ache back of legs omg cramps.back of legs knock me to ground feet tingle front top legs so sore back aches leaning over doctor said give up my job this is brilliant i will definitely dont think its my S1 now.will do test's in morning and see ty so much
Hey Sharon! Thanks for sharing. Doesn't sound like SI joint to me!
No pressure, but if you're looking for a different approach and are interested in some help, I'd be happy to review your case personally.
If you'd like, just visit www.drcharliejohnsonpt.com/apply - select a time to chat and follow instructions to submit a Case Review!
Thanks for watching,
Dr. Charlie
Can i find your book in Dutch? This video os difficult to understand..but looks very intressted
I know for sure its SI joint problem now.
Awesome glad I could help you pinpoint it.
What’s your plan for treatment?
Let me know if you have any questions or get stuck!
Dr Charlie
I am here because I have back/butt/leg pain and it starts below the belt line and goes all the way down the outside/front of thigh, knee, shin and top of foot. But also I have pain in my calf acylase tendon area and hamstring (but the hamstrings are really only noticeable when I sit). I have this pain on both sides the symptoms are sometimes worse on one side sometimes they are present on both sides. I have good days and bad days. Usually its several bad days but one side will hurt one day then the next day its the opposite side then lower back (blow the belt line) and hamstrings. I have gone through all these tests, I don't have centralization, SOME (as in a little pain in the foot) prolifililization during the tests doing several reps of each. The only thing that seems to have lowed the pain is time and rest. Over time the pain doesn't go as far down and is less intense (again on my bad days, my good days hardly any pain). I fail the fortin test on the left side but pass pressing on the middle or right side of my sacrum there is nothing and the other tests don't produce pain. Pressing on my back near the spine does nothing. I have zero loss of feeling, zero loss of motor control in ether side have good reflexes and some nerve stretch sensitivity. It seems sleeping on my side, right or left SOMETIMES (most of the time I can sleep on my right side with no problems) I wake up in pain or manifests later in the day. Most of the time sleeping on my back makes it feel better. I have gotten a lumbar injunction and si joint injection nether had significant pain reduction. this have been going on for 10 months (sorta). in febuary I was doind RDLs wrong and too much weight overloded my back felt a pop. Started having siadica like symptoms 4 days later did some streaches for a few days, made it worse then got medical attention. I was told to go on youtube for excersises, I did that and about a month later I was mostly better. Well july rolled around, out of anger kicked a door several times then the symptoms I mentioned above happened and have vary slowly have been getting better since. I, or PT or doctor have't been able to figure out what is the cause or what helps besides time.
Hey Ronin! Thanks for watching- sorry to hear about what you’re dealing with- no fun. Common that not everything lines up 100%.
Glad you’re slowly getting better, but seems like you’re a bit stuck in trying to really solve this. Need to do some more detective work here…
No pressure, but if you’re looking for more help- I’d be be happy to review your complete case and see if/how I may be able to help.
If you’re interested, just visit www.drcharliejohnsonpt.com/apply - select a time to chat and the follow instructions to submit your case.
Hang in there Ronin!
Thanks for sharing your story.
Dr Charlie
I just spent 4 days in the hospital after dealing with low back spasms of varying degrees for 10 days that became severe enough that I couldn't get out of bed. I'd been having SI pain flares for several months. Chiropractor care helped some. Sure wish I'd seen this 1st. CT and MRI show some mild stenosis and disc degeneration with arthritis esp @L5SI. I'm 73 yrs old and very active teaching TRX and mat Pilates 2x each weekly. PCP thinks MRI shows a "shadow" ON L5-postulates a stress fracture-my last DEXA was a yr and a half ago Minimal osteopenia in my hip and one femur. Getting another DEXA late Dec. now pain is back to that left SI, SI belt helps a lot plus infared heat pad. Any other suggestions would be welcomed BTW I'm a retired RN and had my fair share of pt initiatal low back injuries and several bouts of "light duty" lasting 3 months @a time. 2 auto accidents as well:(
Hey Christina! Thanks for watching and I appreciate you sharing some of your story. Sorry to hear.
Honestly, would need more details and to do some detective work to give recommendations and see even if I can help you solve this.
Would you be open to submitting more details of your specific case and setting up a time to chat so that I can confirm either way if I can help and what that might look like?
Dr Charlie
I had a c/t exam and there was a mention of a disc but also a mention of my arthritis.
I went to an orthopedic doctor and he said that he couldn't help me and I need to go to a pain specialist. I have had this problem for 4 years and it's been very debilitating. I'm now waiting for insurance approval.
Hey Susan! Sorry to hear. Thanks for watching.
Let me know if you’re interested in some help. Would be happy to review your case 👍
Hang in there.
Charlie
It's so hard living like this! We are retired and living on a fixed income. I desperately need this and don't want to be an invalid.
Please advise me of the cost, I guess I could put on my charge card. I want my life back. Thank you.
Regards, Susan Viereck
Question...If you have an UPSTREAM, Centralized Issue, can you experience a pain in SI region that FEELS LIKE an Ice Pick is being jabbed into that joint in one spot??
Thanks Dr Charlie!
Hey Sheila! Happy new year! Great question. YES! A spine issue (upstream) can cause you to feel a stabbing pain in the SI Joint region or buttock that feels like an ice pick/localized area of pain. However, SI Joint issues can also cause localized pain over the SI Joint (fortin finger sign). Hope this answers your question.
No pressure, but if you feel stuck and are interested in some help- I'd be happy to review your case and see if/how I may be able to guide you. Just let me know!
Okay?
Thanks Sheila!
Dr. Charlie
28k views, 8 months ago with 888 likes. 8 is a very good number.
I am 99% sure my pain is from my SI joint as it stems from that boney lower right of my sacrum. I have to sit to one side in chairs but I have been dealing with it for over a year and recently pain has been so bad I have to crawl out of bed to the floor in the morning for over an hour. I also have that crooked hip hike when walking but my question for you is what info do you know of for SI joint issues as it pertains to having a lumbarized S1 as this was noticed on a recent xray and ct scan I had this past year? Could I have more of a symptom of bertolotti's syndrome?
My lower back pain is killing me what can I do
I originally hurt my low back doing a super golf swing at 15 years old. reinjured it multiple times bodybuilding in 20s/30s. at 43 I feel like a slab of concrete. I am still physical but it takes a ton of mental effort to work through the pain. I went to PT had MRI and they feel like my facet joints are the issue. my L5 has a fissure and is degenerated but they do not feel like thats my pain source. Pain is right sidelow back lots of top butt,groin some hip. Ive had this for 20 years but its mad at me lately. even bending over 1 inch to brush teeth in sink can send my back into a spitz. Not sure i should get 2nd opinion before i get injections in the facets. cause it does feel more in my SI area most of the time if i really focus in on the pain
Hey! Thanks for watching and appreciate you sharing your story. Sorry hear. Seems like you’ve been through a lot.
Injections are an option- but its usually a downhill slide from there (one injection leading to another and so on…)
No pressure, but if you’re interested I’d be happy to review your case and see even if/how I may be able to help (I consult with folks worldwide and this is my specialty).
If you’d like- feel free to submit details of your specific case by submitting a “case review” and setting up a brief time to chat- just visit www.drcharliejohnsonpt.com/apply and follow the instructions.
Hang in there!
My problem is this.
Scott! Whats up! Thanks for watching!
Where are you located? I'd like to visit your practice
Hey! Do not see clients in person- goal is to teach you what you need to do to resolve your pain naturally. And so, we consult with folks worldwide.
If you’re interested in potentially working together, visit- www.drcharliejohnsonpt.com/apply and set up a time to chat. Then, submit your case for me to review 👍
I got a Si injection and a facet joint injection nothing worked 🙄 perhaps an epidural might work. I have exhausted all types of PT
Sorry to hear- but very common that injections don’t work- and certainly don’t work long term.
Not sure what your PT looked like but it’s possible they didn’t follow a systematic or scientific approach to resolving this? If they provided you with a sheet of exercises and treatments- then it will be very difficult to determine what works.
Make sense?
Would you be open to having me review your case to see if/how I may be able to help?
If so- just visit www.drcharliejohnsonpt.com/apply- select a time to chat, then follow instructions to submit a formal “case review.”
Hang in there 👊🏼
Dr Charlie
What state are you in
A terrible one lol
So I’ve worked out it’s not a back or nerve problem. Pretty sure it’s not SI but thinking it’s Piriformis or glute tendonopathy I have.
I’ve stopped doing lots of stretching and started doing clam exercises with walking.
How can I tell the difference between Piriformis or gluteal tendonopathy ??
Interesting 1 in 4 menopausal women get hip pain !!
Your videos are just brilliant and make so much sense.
Hey Karen! Thanks for watching! Gluteal tendinopathy generally causes lateral hip pain as the glute tendons attach here (similar in location to) hip “bursitis” pain location on the outer side of hip.
Piriformis syndrome presents as central buttock pain with it without leg pain.
That being said, I’d honestly need more details to help give ya clarity here and to see if I can help problem solve this.
Would you be open to submitting details of your case and setting up a time to chat with us so that I can confirm either way?
Let me know.
Thanks Karen!! 👍
Where is your office?
Hey Cathy! thanks for watching. I'm based in southeastern Pennsylvania- but consult with folks virtually all over the world (infact, I don't work with anyone in person and have not for years).
Are you interested in some help?
Why know it if you cannot get rid of it ?
If nothing else, at least it allows you to stop searching for answers 🤷🏽♂️
Why would you not first and foremost recommend going to a chiropractor. This is their realm
Hey! A couple reasons I don't first and foremost recommend this-
1. Because I believe people should be taught to heal themselves. Manual therapy (hands on treatment) can be helpful for some, but, in my experience, it fosters long term dependency on someone else to "fix you." (I used to teach manual therapy and utilize it heavily in practice... then discovered that it works well in the moment, but doesn't teach people how to help themselves long term... so, I no longer do it).
2. Nocebo language and faulty narratives, albiet not unique to chiropractors alone, is/are commonly used for people who experience symptoms in this area. Statements such as, your pelvis is out of alignment, your hips are rotated, your leg is longer than the other... have little to no scientific backing and actually fuel the fear + pain cycle.
3. In what way is this anymore within a chiropractors "realm" than someone like myself or another provider who's specialized in this area and provides evidence based treatment surrounding
pain/conservative treatment?
Dr. Charlie
@@drcharliejohnson All I can say is that as someone who has had weeks worth of spasms and some of the worst pain I have experienced in my life, if not for a chiropractor I have no idea how I would have gotten better. This was partly due to a bad chiro (the guy at the local clinic) sending me to a hospital for help because he was more concerned about liability than helping, only to be made worse by a medical system that failed to diagnose and did not treat the issue. I finally got to the point I could walk again from being stuck in a bed, so signed myself out, found a different chiro through reference. He looked at me for a few minutes, assessed, a few minutes later I felt the joint go back in place. Its a crazy feeling.
Fair since then I have had the problem come up a few times(probably 4 times in the past 6 years, but generally get it taken care of the next day so it doesn't get bad) and now I have finally started to look at what exercises I can do in the meantime while waiting for an appointment if it does take a few days and that is how I came across your video. I just know there are a lot of professionals out there that ignore the contribution that chiropractors bring and something like this needs to be dealt with asap, especially if the person doesn't get how bad it will get how quick. I'll walk in the office barely able to stand and after some stretches and adjustment I will walk out 100% (if it takes a few days I'm still sore, but not getting worse). Its pretty wild.
and for the record, where I live we wouldn't even have access to a PT except through the medical system and all they are concerned with is giving pain killers and then trying to figure out what other drug to give you. The best options I have around here that are free of that system are chiros and MTs.
This is worrying. Simply put, what this creator does, is similar to claiming that one of the causes of the common cold is "coughing".
The creator uses the prefix "Dr." misleadingly, as "Dr. [name]" is used by people with a medical degree in the context of healthcare. In this case, it is used to refer to a PhD in physiotherapy, ie: a person who can teach physio therapy. Note: the creator is not a specialist within diagnostics, he is a specialist within conservative treatment. Lower back pain is notoriously difficult to diagnose correctly, and physical examination alone has low specificity and sensitivity. The symptoms of the various causes of lower back pain overlap to a very high degree. No single diagnostic test is enough, but physical examination must be combined with the patients history, scans and possibly injections. Note: even injections at the SI-joint can only diagnose it as the cause if pain relief > 75%.
The reason i point this out, is the medical errors in this video.
"Radicular nerve pain" is cited as a "source of pain", instead of a symptom of nerve root compression. A painful disc herniation is always caused by radicular nerve compression. It thus does not make sense to list both "disc herniations" and "radicular nerve pain" as different causes. One is the pathogenesis, the other a symptom of it.
The straight leg raise test (laseques test) tests for sciatica caused by nerve root compression, specifically in L5-S1. A positive lasegues test is an indication of disc herniation.
Note: SCIATICA is a symptom of many causes of lower back pain(!) Sciatica is NOT a diagnosis, contrary to what is claimed in this video, but simply pain along the sciatic nerve (down the leg).
The most likely cause of sciatica is disc herniation.
This also means that sciatic pain moving proximal or distal along the sciatic nerve is a symptom of increasing/decreasing nerve compression in various causes of lower back pain, including SI-joint, contrary to what is claimed in this video.
So, the method in this video does not have a "high probability" to correctly diagnose your cause of lower back pain.
Hey- thanks for your feedback... but if I'm being completely honest- your comment is worrying, here's why:
1. I'm not using the term "Doctor" in a misleading way. I'm a doctor of physical therapy (DPT) which refers to a clinical doctorate in the healthcare field (medical degree). Just like a Doctor of Osteopathic medicine is a DO, or Doctor of chiropractic is a DC... this is different than a PhD which is an academic doctorate. Here in the USA you must have a clinical doctorate (DPT) AND a PhD or DSC (academic degrees) or a board speciality in order to "teach physiotherapy." I am a practicing doctor of physical therapy... nothing misleading about that. Beyond the general Doctorate in PT (DPT) degree I am residency trained and board specialized in orthopedics (OCS) and only treat people with back, butt, and sciatica pains... which places my knowledge and experience in the top 0.5% of PTs in the USA alone.
2. It seems as though you did not watch the entire training. Diagnostics do go beyond a physical examination- I agree... which is why I include elements of the patient history/demographics as part of the evaluation. Also, if you watched the training, no one physical test is taken as diagnostic- but rather a test item CLUSTER is identified, in conjunction with various other elements, which aims to shift the probability of SIJ as the source of symptoms.(diagnostics occur in probabilities- not absolutes).
3. Not sure what you're referring to as "medical errors?" Radicular nerve pain does NOT automatically indicate nerve compression (radiculopathy). One can have radicular pain without nerve compression (radiculopathy). Radiculopathy could be defined loosely as "nerve compression" if you will- denoted by objective motor or sensory loss. Leg pain and nerve symptoms that extend below the level of the knee into the foot- usually associated with a + SLR can occur in the absence of nerve compression- as the dorsal root ganglion becomes sensitized resulting in peripheral neuropathic pain. Radicular pain = peripheral neuropathic pain due to nerve sensitzation. Radiculopathy = a state of objective neurological LOSS/deficit which may or may NOT be associated with radicular pain. They are not "one in the same."
A painful disc herniation is NOT caused by "radicular nerve compression" (whatever that means). The outer third of the annulus is innervated by the sinuvertebral nerve- which allows the disc itself (in the absence of nerve compression) to cause local or referred pain into the butt or leg. The sinuvertebral nerve is a recurrent branch of the ventral rami and studies show that sinuvertebral nerve blocks can reduce discogenic pain (pain of disc origin).
Again, discogenic pain (somatic referred pain from the disc ALONE without nerve involvement) and radicular pain (peripheral neuropathic pain) can occur independent of one another... although as you mentioned- the #1 cause of radicular pain is a disc issue. Not everyone who has a disc herniation has nerve compression. And not everyone who has nerve compression has a disc herniation.
The SLR test does NOT test for sciatica caused by nerve compression. It tests for peripheral nerve sensitivity (sensitivity of the sciatic nerve). A + SLR does not indicate that there is nerve compression. Many people will have a + SLR without signs of nerve compression... no objective loss of sensory or motor function (feeling or strength)... in which case, the nervous system is sensitized.. but not compressed. We would refer to this as radicular pain. There may be times where someone has a + SLR WITH objective sensory or motor loss- we would call this radiculopathy. (Theres a difference between radicular pain and radiculopathy). The SLR is a highly SENSITIVE test- and when negative can effectively rule out "sciatica."
You're right, sciatica can be caused by many things... but the peripheral nervous system can still be a source of pain no doubt. The video reflects this- as it aims to help folks determine the most likely pain driver (disc, facet, SIJ, peripheral neuropathic pain PNP/sciatica). Not sure why you're getting tripped up here regarding semantics of sciatica being a symptom of something greater or not. The sciatic nerve alone can cause symptoms, just as a disc, facet, or SIJ can. I've seen cases of runners for example- who suddenly stretch their nerve while sprinting... and develop "sciatica" pain... no signs of disc, facet, SIJ pain were present. Why could irritation of the sciatic nerve alone be a cause of symptoms... does it need to always be caused by "something else?"
"Sciatic pain" moving proximal or distal along the sciatic nerve has nothing to do with the extent of nerve compression. First off, as mentioned above, sciatica can be present in the ABSENCE of nerve compression. Pain in the leg may also be due to somatic referred pain alone as well- no nerve irritation required to experience leg pain (disc, facet, SIJ all have well documented somatic pain referral patterns into the butt and leg). Movement of symptoms from distal to proximal or the other way around may indicate centralization or peripheralization- which is SPECIFIC or diagnostic of a discogenic source of symptoms... it does not necessarily mean more or less nerve compression- or indicate any nerve compression for that matter.
We have no evidence that SIJ pain (pain arising from the SIJ) can cause "nerve compression."
The evaluation flow/sequence and diagnostic criterion in this video has been established as a reliable and valid way to evaluate for the presence of SIJ pain when compared to the gold standard diagnostic test- an SIJ injection.
That being said, one could for sure argue that this drops with self-administration of tests and interpretation of test results- and I would agree that this is very likely true.
You could also include scans and injections into the mix here to strengthen the diagnostic probability... but, if a clinical exam (including story + patient demographics, location or pain, neuro/physical exam and test item clusters) can be performed and has been shown to arrive at a high post test probability of SIJ as the source of symptoms... why bother?! Especially knowing how little diagnostic utility MRI's/xrays have in determining the source of back pain AND how the prognosis of folks who receive imaging is far WORSE than those who do not?
I do agree that determining the source of back pain is challenging- no doubt. But this is why we treat the pain experience and person- not scans and the diagnosis.
Dr. Charlie
1: You have not studied medicine, and you continue to mislead your viewers with this response of yours, where you indirectly equate your degree to degrees in medicine.
en.wikipedia.org/wiki/Doctor_of_Physical_Therapy#Controversies
There's a reason you don't see nurses with a PhD calling themselves "Dr.", but apparently they ought to by your moral standards.
2: Physical tests (plural) alone have low specificity. The probably of a correct diagnosis are only high when combining different diagnostic tools.
3: Quote: "A painful disc herniation is NOT caused by "radicular nerve compression" (whatever that means)."
Radicular means "small root" in latin...
Lasegues test increases pressure on the nerve root/radicular nerve. This is what the straight leg raise test is for, which in the vast majority of cases means a disc herniation if positively true.
"Nerve" is not a cause, it is not a diagnosis. This fanthom of sciatic nerve pain without a cause has no scientific basis. The pain from nerve irritation is felt distal from the point of irritation (inflammation, compression etc). A peripheral nerve problem will not cause proximal back pain (anatomically impossible).
Quote: "Sciatic pain" moving proximal or distal along the sciatic nerve has nothing to do with the extent of nerve compression."
Wrong. This mechanism is the basis of the SLR/Lasegues test.
@@Northern85Starthis is super silly. Before I respond- If I may ask, what is your foundation for this discussion.... what degree and/or clinical experience do you base your response upon?