Professional Documents
Culture Documents
Sciatica: Name: Muzdalfa Qureshi Subject: Supervised Clinical Practice ROLLNUMBER:18221 Submitted To: DR Abdul Rashad
Sciatica: Name: Muzdalfa Qureshi Subject: Supervised Clinical Practice ROLLNUMBER:18221 Submitted To: DR Abdul Rashad
Sciatica: Name: Muzdalfa Qureshi Subject: Supervised Clinical Practice ROLLNUMBER:18221 Submitted To: DR Abdul Rashad
• E T I O LO G Y
• ONSET
• TO P O G R A P H Y
• Clinical pictures
• C L I N IC A L E X A M I N AT I O N
• C L I N IC A L F O R M S O F S C I AT I C A
• DI F F E R E N T I A L DI A G N O S I S
• IMAGING
• T R E AT M E N T
• C L I N IC A L C A S E ST U DY F O R S C I AT I C A
2
SCIATICA
• Sciatica is pain in the lower extremity resulti ng
from irritati on of the sciati c nerve. The pain of
sciatica is typically felt from the low back (lumbar
area) to behind the thigh and radiati ng down
below the knee & may reach the foot .
• Disc herniation
• Spinal stenosis
• PIRIFORMIS SYNDROME:
• Spondylolisthesis :
• other causes :
4
Disc herniation :
• S p on dy lo list he sis : d e g e n e ra t i v e c a u s e o f s p i n a l s t e n o s i s
w h i c h i s a n t e r i o r o r p o s t e r i o r d i s p l a c e m e n t o f v e r t e b ra .
• PAIN: T he mo st c om m on s ym pt o m f r om s c ia t i ca .
Mo st pe op le d e sc r ib e a d e ep, se ve re p a i n t hat
s ta r t s l ow on o ne si d e of t he b a ck a nd t hen s hoot s
do wn the b ut toc k a nd t he le g wi t h c er t a i n
movem ent s . In m os t pe op l e, t he pa i n i s m a de
wor s e b y sne e z i ng , c oug hing , l a ug hi ng, or a ha r d
bo we l move m ent . Be ndi ng b a ck wa r d ca n a ls o ma ke
the p a i n w ors e . You may a ls o n oti c e a w ea kne s s of
the l e g or foot , a lo ng wi th the p a i n. The w ea k nes s
may be c om e so b ad pa t ie nt c an' t m ove his foot
• Numbness.
• H I P I S F L E X E D & T H E K N E E I S A L S O F L E X E D AT 9 0 D E G R E E S
• T H E K N E E I S T H E N G R A D U A L LY E X T E N D E D B Y T H E E X A M I N E R .
• I F N E R V E ST R E TC T H I S P R E S E N T: PAT I E N T W I L L E X P E R I E N C E
PA I N I N T H E B A C K O F T H I G H O R L E G .
HYPERALGIC SCIATICA
• C h a ra c t e r i z e d b y s e v e r e p a i n
• P a t i e n t p r e f e r s t o r e m a i n i n b e d & i s h e s i t a n t e v e n t o m o v e s l i g h t l y.
• S p e c i fi c f o r m : m ya l g i c s c i a t i c a
• S e e n m o s t c o m m o n l y i n d i s c h e e r n i a t i o n s a ff e c t i n g S 1 n e r v e r o o t .
• M i l d m o t o r d e fi c i t .
• Fa s c i c u l a t i o n ' s
13
PARALYTIC SCIATICA
• Sli g ht m oto r de fi c i t ca n be
de te cte d .
• Mor e fr e q uent i n L 5 s ci a ti c a
• Mos t of te n pa ra l yt ic L5 s ci a ti ca
le a ds to fo ot dr op, whi ch fo rc e s
the p a ti en t to mo di fy t he g ai t
pa t te r n.
14
DIFFERENTIAL DIAGNOSIS
• S P O N DY LOA RT H R O PAT H Y
• Pa i n d o e s n o t r e fe r d i s t a l t o t h e k n e e .
• B i l a t e ra l o r a l te rn a t i n g o c c u r i n g e p i s o d i c a l l y.
• N o t m od i fi e d b y a c ti v i ty.
• D i a g n o s i s : PA V i e w s o f p e l v i s o r s p e c i a l i z e d h i b b s v i e w o f t h e s a c r o i l l i a c j o i n t s .
• E S R i s e l e va t e d .
• Ra p i d r e s p o n e t o m e d i c a t i o n .
• I N T R A M E D U L L A RY T U M O U R S ( G L IO MA S )
• Noct urna l p a in is co mm on 15
• Pa t i ent w il l s ta nd o r wa lk t o b ri ng r el i ef.
• Infe ct i ous d is c it i s
• Infe ct i ous s a cr o il l it is
16
IMAGING
• R A DIOGR AP H Y Mos t oc ca s io ns ra d i ogra phs is no rm a l Los s of lum b ar lor d io s is
Sco li os is Re duc ed i nt er ver t eb ra l d i sc s p s ce .
• DI SCOG RA P H Y Of t en ne g le c te d mo d al i ty Exc el le nt m ea ns of a s se s i ng di s c
pa t hol og y
• CONSERVATIVE MANAGEMENT
H ea t /co ld a p pl i ca t io n
TREATMENT
• SURGERY
Whe n ne ur ol ogi c al de fi c it is p r e se nt
• REHABILITATION
T HE RA P E UT IC E XER CI SES
19
20
20
CLINICAL CASE STUDY FOR SCIATICA
• NAME:ABC..
• M a l e R . C ., A G E : 4 0 y e a r o l d – S c i a t i c a
• A patient was presented with the exacerbated chronic lower back pain in the Sacral region with irradiation
t o t h e b a c k o f t h e l e f t l e g , p r o d u c i n g a s t r o n g p a i n t h r o b b i n g a n d b u r n i n g b e h i n d t h e k n e e . Pa i n w a s
aggravated when bending forward or in reaching out position.
• In his history he had a back condition from birth and later had an accident that resulted in fracture of the
l u m b a r v e r t e b r a e . F r o m t i m e t o t i m e h e s u ff e r e d w i t h t y p i c a l s c i a t i c a p a i n . T h i s t i m e h e h a s b e e n s u ff e r i n g
for about two weeks.
• His MRI two months prior to this aggravation showed degeneration of L1, disc degeneration, and protrusion
of the disc at the S1 level.
• H e w a s p r e s c r i b e d s t r o n g n o n - s t e r o i d p a i n m e d i c a t i o n t h a t m a d e h i m f e e l d r o w s y, b u t d i d n o t p r o v i d e a f u l l
p a i n r e l i e f. S e e k i n g r e s o l u t i o n f o r h i s p a i n h e d e c i d e d t o t r y I n t e r X t h e r a p y.
• T h e fi r s t t r e a t m e n t h e f e l t t h e p a i n s u b s i d e , b u t p a i n r e l i e f d i d n ’ t l a s t a n d t h e p a i n r e o c c u r r e d a f t e r a f e w
hours.
21
CLINICAL CASE STUDY FOR SCIATICA
• T h e se c o n d t re a tm e n t alt ho u gh p ain te mp or a r ily re du c e d , la te r h e fe lt w or s e . F ro m th a t p oin t a n d
on w a r ds h e us e d th e P er s o na l In te r X de vic e to s us ta in pa in re lie f. He h ad to g o a b ro ad a nd t oo k his
p e r so n a l I nt e r X d e v i c e w it h th e d u al fle x ar r a y fo r e ve r y d ay tre atm e n t p roto c ol th a t I s up p lie d h im
w ith .
25