Skills PracticumSkills Practicum

You – Are working in the Poly-You – Are working in the Poly-Clinic Clinic

Your patient: Is a 33 year old Your patient: Is a 33 year old male male

Patient historyPatient history

Patient works in the warehouse moving boxes and supplies around daily.

He has been in the job for 10 yearsPatient chief complaint is: pain, weakness,

numbness, and tingling in his right leg.

What do you do?What do you do?

BP 122/88Pulse 90Respirations 18Temperature 36.5 CelsiusPulse Oximetry 93% on room air

What would you ask the patient?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 Patient states the pain increases with:with:

After standing or sittingAt nightWhen sneezing, coughing, or laughingWhen bending backwards or walking more

than a few yards

Patient states: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 What do you think is going on with the patient?with the patient?

What tests do you think the Doctor may want to order?

SciaticaSciatica

Neuropathy - sciatic nerve; Sciatic nerve dysfunction

Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated.

TreatmentsTreatments

Conservative treatment is best in many cases.

Apply heat or ice to the painful area. Try ice for the first 48 - 72 hours, then use heat after that.

Take over-the-counter pain relievers

Common causes of sciatica includeCommon causes of sciatica include

Piriformis syndrome (a pain disorder involving the narrow piriformis muscle in the buttocks)

Slipped diskDegenerative disk diseaseSpinal stenosisPelvic injury or fractureTumors

ComplicationsComplications

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 concernsAcute concerns

Unexplained fever with back painBack pain after a severe blow or fallRedness or swelling on the back or spinePain traveling down your legs below the kneeWeakness or numbness in your buttocks, thigh,

leg, or pelvisBurning with urination or blood in your urinePain that is worse when you lie down, or awakens

you at nightSevere pain and you cannot get comfortableLoss of control of urine or stool (incontinence)