Acute Sciatica - need suggestion

[sdkashif]

Your pt case presentation is not fully complete. Describe it in a little bit more detail. It will be better to use the McKenzie Assessment approach, so that the condition of your patient is better analysed. An example of McKenzie assessment approach is given below to follow. Have a look over that.

Date--------------
Name--------------------------- Sex M / F
Address---------------------------------
Telephone-----------------------------
Date of Birth---------------------------- Age-----------------------
Referral: GP / Orth / Self / Other-------------------------
Work: Mechanical Stresses-----------------------
Leisure: Mechanical Stresses------------------------------
Functional Disability from present episode--------------------
Functional Disability score---------------------------------------
VAS Score (0-10)------------------------------------------

HISTORY

Present Symptoms---------------------------------------
Present since--------- Improving / Unchanging / Worsening-----------
Commenced as a result of------------- Or no apparent reason-----------
Symptoms at onset: back / thigh / leg----------------------------------
Constant symptoms: back / thigh / leg--------------------------------- Intermittent symptoms: back / thigh / leg-----------------------------

Worse: bending Sitting / rising standing walking l ying
am / as the day progresses / pm when still / on the move
other

Better: bending sitting standing walking lying
am / as the day progresses / pm when still / on the move
other

Disturbed Sleep Yes / No

Sleeping postures: prone / sup / side R / L
Surface: firm / soft / sag
Previous Episodes 0 1-5 6-10 11+
Year of first episode
Previous History--------------------------------------
Previous Treatments-----------------------------------

SPECIFIC QUESTIONS

Cough / Sneeze / Strain / +ve / -ve
Bladder: normal / abnormal
Gait: normal / abnormal
Medications: Nil / NSAIDS / Analg / Steroids / Anticoag / Other------------
General Health: Good / Fair / Poor--------------------
Imaging: Yes / No---------------------------------------------
Recent or major surgery: Yes / No ---------------
Night Pain: Yes / No---------------------
Accidents: Yes / No ----------------------
Unexplained weight loss: Yes / No---------------------

POSTURE

Sitting: Good / Fair / Poor Standing: Good / Fair / Poor Lordosis: Red / Acc / Normal Lateral Shift: Right / Left / Nil
Correction of Posture: Better / Worse / No effect------------- Relevant: Yes / No------------------
Other Observations:--------------------

NEUROLOGICAL

Motor Deficit Reflexes
Sensory Deficit Dural Signs

MOVEMENT LOSS

Movement Loss Maj Mod Min Nil Pain

Flexion
Extension
Side Gliding R
Side Gliding L

TEST MOVEMENTS Describe effect on present pain – During: produces, abolishes, increases, decreases, no effect,
centralising, peripheralising. After: better, worse, no better, no worse, no effect, centralised, peripheralised.

Mechanical Response
Symptoms During Testing Symptoms After Testing
Rom Rom No
Effect
Pretest symptoms standing:
FIS
Rep FIS
EIS
Rep EIS
Pretest symptoms lying:
FIL
Rep FIL
EIL
Rep EIL
If required pretest symptoms:
SGIS – R
Rep SGIS - R
SGIS - L
Rep SGIS- L

STATIC TESTS

Sitting slouched---------------------- Sitting erect---------------------
Standing slouched---------------- Standing erect-----------------------
Lying prone in extension--------------- Long sitting--------------------

OTHER TESTS--------------------------------------------------

PROVISIONAL CLASSIFICATION

Derangement Dysfunction Posture Other
Derangement: Pain location------------------------------------

PRINCIPLE OF MANAGEMENT

Education------------------- Equipment Provided------------------------
Mechanical Therapy: Yes / No--------------------------------------
Extension Principle:------------------- Lateral Principle:--------------------
Flexion Principle:---------------------- Other:------------------------
Treatment Goals:----------------------------------------------------

McKenzie forms are as an attachment. Have a look over that.