Sciatica

Radiating pain down posterior lower extremity -Compression of lumbro-sacral nerve roots that comprise the sciatic nerve - L4-S3

History
-OPQRST -localization, diffuse, radicular, referred Mechanics -Movement: muscular & neuro -Visceral: Constant, < night -Nerve Root Compression - disc protrusion, intraspinal tumor --valsalva (straining, coughing, sneezing) --Decrease SLR --Decrease DTR --Sensory changes

Physical Exam
Inspection: lordosis, pelvic tilt Flexion/extension/lateral bending Palpation: height of iliac crests, PSIS Tightness of paravertebral muscles Tenderness over lumbar spine, lumbrosacral joint, SI joints, sciatic nerve (halfway between greater trochanter & ischial tuberosity) ROM of hips Leg length Orthopedic tests: Straight leg raise (lasegue's) w/ Braggard's, Gaenslen's, Patrick's Neuro examination: Deep Tendon Reflex's; muscle strength - tibialis anterior, extensor digitorum longus; sensory deficits -pinprick

Imaging
-X-rays -MRI

Treatment
-Rest -NSAIDS, muscle relaxants -Heat, diathermy after acute phase -Lumbrosacral belt -Exercises -Naturo: massage, manipulation, vitamin C, acupuncture (BL-23, GV-4, BL-25, GV-3, Yao Yan)

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= = =Treatment= -Epsom Salts Bath