Sciatica
Age: years old
Gender:
HISTORY:
Presents with a - history of
Onset was , started
Location is
Radiation to
Rated at / 10
Described as
Pattern
Worsening factors:
Alleviating factors: ,
Occupation:
Associated symptoms: *Try using right-click for negatives*
, , ,
, up to °, over
, over
Contributing factors:
no history of: , , , , , , ,
no use of:
EXAM:
Low back:
Inspection:
Palpation:
Range of motion:
- Flexion:
- Extension:
- Right bending:
- Left bending:
- Right rotation:
- Left rotation:
Strength: throughout lower extremities, except on
Sensation: throughout lower extremities, except on
Reflexes: throughout lower extremities, except on
Special tests:
- Straight leg raise:
- Crossed straight leg raise:
- Tripod:
- Faber test:
Gait:
ASSESSMENT:
DDx: lumbar sprain, lumbar radiculopathy, disc herniation, lumbar spinal stenosis, spondylolisthesis, piriformis syndrome, lumbar spondylosis, spinal tumors, cauda equina syndrome, vertebral fracture, ankylosing spondylitis, epidural abscess, referred pain from hip pathology, sacroiliac joint dysfunction, pelvic pathology, peripheral neuropathy, herpes zoster infection, abdominal aortic aneurysm, deep vein thrombosis, cellulitis, knee osteoarthritis, muscle strain, peripheral vascular disease
PLAN:
Investigations:
- Lumbar X-ray
- CT scan of lumbar spine
- MRI of lumbar spine
- Nerve conduction studies
- Electromyography
Treatments:
- Advised that the condition is likely benign and that they should remain active as tolerated
- Encouraged to stretch, keep good posture, and avoid lifting weight
- Heat or cold therapy
- Physical therapy
-
-
-
-
- for
Further care:
- Referral to orthopedic surgeon
- Referral to pain management specialist
- Referral to neurologist
- Follow-up in
- Return if pain worsens, if new symptoms develop such as fever, unexplained weight loss, leg weakness, urinary or fecal incontinence, saddle numbness, or if symptoms do not improve with treatment
HISTORY: Associated symptoms: EXAM: Low back: ASSESSMENT: PLAN: