This article is a transcribed edited summary of a video Bob and Brad recorded in March of 2022. For the original video go to https://www.youtube.com/watch?v=eAtTjR1tNHk
Bob: We're going to try today to unwrap a mystery. So, if you're female and you're out there and you have long-standing back pain or not even long-standing back pain, but you can't figure it out. We're going to go over some unusual cases here. Actually, it’s not that unusual.
Brad: This is not a sexist thing. There's a lot of science in this.
Bob: We'll go over the reason this occurs. So I had Dr. Abbasi on a podcast. He's a neurosurgeon, a very smart guy. And he said, they found with research, that 22% of the patients who are coming in with back pain is actually an SI problem. Sacroiliac.
Brad: Right there.
Bob: So if this is your spine, and this is the sacrum. It's kind of a triangle-shaped bone and it's attached to the sacrum, and it's attached to the iliac.
Brad: Yeah. You can see how we're moving. There's a joint there and there. And the problem is these joints become unstable. And they're not really meant to move a lot.
Bob: No, they aren't. And because there are nerves that go by it, they can send pain all the way down your leg. That's what throws the doctors off, Brad.
Brad: Similar to sciatica.
Bob: Yeah. They think sciatic, but they look at the low back and there are no problems. We're going to go over the signs that you might have this. And hopefully, it will help you because it's called the chameleon joint. Because it's like a chameleon. It's weird. So, a typical patient is often female. She often recently gave birth. And that makes sense because when you give birth these ligaments become lax so that the baby can come out of the canal.
Brad: Right. Yeah, so then things spread, and there is a movement going on in those cases. That's why this is more of a female issue.
Bob: It often hurts going up and down stairs which makes sense. The person often is a runner, which also makes sense, because you've got some pounding.
Brad: The impact.
Bob: I also just recently had a patient who fit in this category and she was only 17. Obviously, she did not have a baby but she was super flexible. She could easily do the splits, either way, you know, sideways.
Brad: Yeah. That's kind of a genetic thing with her.
Bob: And her mom who was 47 years old, could still do the splits.
Brad: Yeah. So, runs in the family.
Bob: So she was lax in that SI joint. She also had pain all the way down her leg. And so the doctors were perplexed and leave it to Bob and Brad to solve the problem.
Brad: Yes. Well, there you go again.
Bob: So what they do to make sure well, the other thing, Brad, I was going to mention is when you turn in bed, they often have pain. So, the pain could go all the way into the foot. It's actually, now another situation, Brad, where you might see it is in somebody who had a fused back. If their back was fused now, the movement has to come from somewhere. So it goes more into the SI.
Brad: So typically, if it's fused as a result of surgery because they had back problems. Not necessarily though, it could be caused by something else.
Bob: The number of people who get it then is 43%. So a lot higher. So how can you tell whether or not you have this? Well, first off, if you have any of the history that we just mentioned. I'm going to show you one test you can do. This is a Dr. Abbasi test. He made it up himself actually. Let's say you have pain on the right side, you're going to take that right foot and try to place it onto the right knee. If you can't even do that, that might be a sign that you have SI problems.
Brad: Yeah, and test compared to the other side as well. Especially if there's no pain on this side it can give you some information.
Bob: So, put the knee up, and then you actually push down and you try to relax while you push it down.
Brad: Let me get some good posture here and so gently push down. And it's a positive test if it hurts.
Bob: If it recreates the pain that you've been having.
Brad: So, it may hurt in the back, and you might feel it go down the leg. It recreates your pain if you want to call it that.
Bob: Right. Now there are other tests the doctor can try. But the most conclusive test they do is they actually inject the joint. With usually a little cortisone. And even if it takes away the pain for a couple of days, it's proof that it was the SI.
Brad: Yeah. It gets, it specifies that joint.
Bob: So, if it is the SI, the cortisone might help. It might actually take it away for good for several years. Or there's actually a surgery they can do where they actually fuse the SI.
Brad: There's the conservative way. We do have a book of a therapist who specializes in SI joint and you know, it's oftentimes for women.
Bob: So you can look up Bob and Brad SI or sacroiliac joint and we will have some treatments you can try. So Brad, do you have anything else to say?
Brad: So for surgery, they inject into the joint?
Bob: Right. But for real surgery, they actually fuse.
Brad: Oh, really. I thought they injected a compound or medicine that actually in a sense fuses it?
Bob: No, no, no.
Brad: No? I was misinformed or misunderstood it.
Bob: So if you want to go to an expert, see Dr. Abbasi. You can go to his website, inspiredspine.com. He is the man on this.
Brad: So he has a private clinic and that's all they do is back treatments. And these really impressive surgeries.
Bob: They are less invasive.
Brad: Right. Yeah. The spine one was amazing too.
Bob: Yeah, and he calls it the magic joint because women would have pain for years. And they'd walk out of that surgery without any pain.
Brad: Yeah. That is magic.
Bob: That is magic. All right. Thanks.
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