Skills Practicum

You – Are working in the Poly- Clinic

Your patient: Is a 33 year old male

Patient history 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.

What do you do? BP 122/88 Pulse 90 Respirations 18 Temperature 36.5 Celsius Pulse Oximetry 93% on room air

What would you ask the patient? What makes the pain worse? What helps relieve the pain? What treatments have you tried?

Patient states the pain increases with: After standing or sitting At night When sneezing, coughing, or laughing When bending backwards or walking more than a few yards

Patient states: 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.

What do you think is going on with the patient? What tests do you think the Doctor may want to order?

Sciatica Neuropathy - sciatic nerve; Sciatic nerve dysfunction Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

Treatments Conservative treatment is best in many cases. Apply heat or ice to the painful area. Try ice for the first hours, then use heat after that. Take over-the-counter pain relievers

Common causes of sciatica include 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

Complications 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

Acute concerns 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)