Transcript Nervous system - sciatica

Skills Practicum
You – Are working in the PolyClinic
Your patient: Is a 33 year old
male
Patient works in the warehouse moving
boxes and supplies around daily.
 He has been in the job for 10 years
 Patient chief complaint is: pain, weakness,
numbness, and tingling in his right leg.
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Patient history
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BP 122/88
Pulse 90
Respirations 18
Temperature 36.5 Celsius
Pulse Oximetry 93% on room air
What do you do?
What makes the pain worse?
 What helps relieve the pain?
 What treatments have you tried?
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What would you ask the patient?
After standing or sitting
 At night
 When sneezing, coughing, or laughing
 When bending backwards or walking more
than a few yards
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Patient states the pain increases
with:
There is a decrease in pain with laying flat
and a pillow under his knees.
 Patient has tried some Diclofenac with
some good effect for controlling pain.
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Patient states:
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What tests do you think the Doctor may
want to order?
What do you think is going on with
the patient?
Neuropathy - sciatic nerve; Sciatic nerve
dysfunction
 Because sciatica is a symptom of another
medical condition, the underlying cause
should be identified and treated.
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Sciatica
Conservative treatment is best in many
cases.
 Apply heat or ice to the painful area. Try
ice for the first 48 - 72 hours, then use
heat after that.
 Take over-the-counter pain relievers
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Treatments
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Piriformis syndrome (a pain disorder
involving the narrow piriformis muscle in
the buttocks)
Slipped disk
Degenerative disk disease
Spinal stenosis
Pelvic injury or fracture
Tumors
Common causes of sciatica include
Partial or complete loss of leg movement
 Partial or complete loss of sensation in the
leg
 Recurrent or unnoticed injury to the leg
 Side effects of medications
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Complications
Unexplained fever with back pain
 Back pain after a severe blow or fall
 Redness or swelling on the back or spine
 Pain traveling down your legs below the knee
 Weakness or numbness in your buttocks, thigh,
leg, or pelvis
 Burning with urination or blood in your urine
 Pain that is worse when you lie down, or
awakens you at night
 Severe pain and you cannot get comfortable
 Loss of control of urine or stool (incontinence)
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Acute concerns