Sciatic N Pain

Question 1

Px

Answer 1

Lower back pain
Gluteal pain
Leg pain
Numbness
Parasthesia
Calf mucle weakness
Foot and toe muscle weakness
Made worse by sitting, sneezing, coughing

Question 2

Causes

Answer 2

Comp or irrit of sciatic N
Most commonly due to prolapsed disc
Also lumbar spine stenosis, disc degen, spondylolithesi, pregnancy.

Question 3

Mx

Answer 3

Anti inflamm eg NSAID, oral steroid
Epidural steroid injecs at root origins
Physio
Surgery

Question 4

Ix

Answer 4

-stretch tests-
Straight leg raise limited by tension of root over prolapsed disc. Raise btw 30-70 deg. Pain would radiate down entire leg.
Tension increased by foot dorsiflex- bragards test
Root tension relieved by flex knee
Press over poplit fossa causes local pain radiating to back.
-flip test-
Knee reflex with bent knee
Then straighten leg and test ankle reflex.
Pt with physic N root compress cannot fully ext leg.
- walk on toes or heels
-rise from squatting