Neuropath 4- Sciatic

taylormaloney's version from 2017-01-31 18:57

Section 1

Question Answer
Sacral Plexus- origins/suppliesOriginates Ventral Rami L4-S4. Supplies buttocks, perineum, and pt of lower limb.
Sciatic N- origins and supplies=L4-S3, supplies post thigh and all below knee.
What is Sciatica?Pain w/ possible numbness/weakness. Radiating along sciatic N pathway, down buttock and through the post leg to the foot.
How is Sciatic Pain classified?Radicuopathy- nerve root compression.
What are the common causes of sciatica?Herniated disc/dislocation of hip, spinal stenosis, piriformis syndrome, pelvic injury, pressure caused by pregnancy, improperly administered gluteal injection, tumors.
What may sciatica feel like?Mild tingling, dull ache, burning sensation, possibly sharp pain.
Is Sciatic pain generally unilateral or bilateral?Unilateral- on one side.
What type of factors would aggravate sciatica?Spending a long time sitting/standing, at night, when sneezing/coughing/laughing, bending backwards, or walking a moderate distance.
What are some diagntostic symptoms?Difficulty bending forward/backward, weakness bending knee, abnormal reflexes, abnormal sensory, Pain w/ lifting the leg straight off table.
How may it be diagnosed?Blood tests, Xrays. MRIs and other imaging.
Sciatic Pain is generally self limiting- However it is common for ....It to recur spontaneously.
How is it treated?Heat, Ice/ Medication/ Reduced activity (acute), physical therapy, Massage, and surgery.
How is it prevented?Regular exercise, good posture, proper techniques while lifting heavy objects.
More common in men or women?Men.

Section 2

Question Answer
What is piriformis syndrome?Compression of the sciatic nerve by the piriformis muscle.
Where does this compression take place?Generally- where both the piriformis/Sciatic N exit through the greater sciatic notch.
Who is most likely to experience piriformis syndrome?40-50 years old, all activity levels, all occupations/
Is it more common in men or women?Women.
What causes piriformis syndrome?Direct or indirect trauma- ex fall on buttocks/MVA
What are the potential results of piriformis trauma?Inflammation, Ischemia, Spasm, and Scar tissue/adhesions/TPs.
What are the other potential causes?Overuse of muscle, postural/positional concerns.
What symptoms are you likely to see w/ Piriformis Synd?Pain, paresthesia, numbness, severe compression leading to 'drop foot'.
Is this condition bilateral or unilateral?Usually considered unilateral.
What other complications may rise from piriformis synd?Pudendal N + Gluteal N compression, Pain in low back/buttock/hip/post thigh, weakness in ABD, flex, Int Rot of affected hip, and SI Joint dysfunction.
How is it treated?Heat/Ice, Medications, Physio/ Steroid Injections, Surgery.

Section 3

Question Answer
How might massage therapy affect or improve symptoms of Sciatica?^ removal of waste products from muscles, Decreases spasm, increase oxygen supply and length of muscles.

Section 4

Question Answer
What is the Tarsal Tunnel?Canal formed by the medial malleolus and flexor retinaculum.
What is found within this tunnel?Nerves, Arteries, Tendons.
What is the major N found within the tarsal tunnell?Tibial N- supplying the sensory feedback in the bottom of the foot.
When the Tibial N is compressed within the tarsal tunnel it is called..Tarsal Tunnel Syndrome- or 'Posterior Tibial Neuralgia'.
What may cause this type of condition?Trauma, edema, ganglion cysts, scars, tumors, and ill-fitting footwear.
What symptoms are likely to be seen in TTS?Shooting pain in foot (worse at night), numbness, tingling/burning, and paresthesias of bottom of foot.
What special test may be used to help diagnose this issue?Tinel's Sign, percussion over tunnel may produce pain.
What other diagnostic tools may be used?Medical History, Comprehensive clinical exam, imaging, electrical testing( EMG ).
How is it treated?Rest, NSAIDs, Steroid injections, Footwear adjustments. Surgical release.