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Skills Practicum You – Are working in the PolyClinic Your patient: Is a 33 year old male 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. Patient history BP 122/88 Pulse 90 Respirations 18 Temperature 36.5 Celsius Pulse Oximetry 93% on room air What do you do? What makes the pain worse? What helps relieve the pain? What treatments have you tried? What would you ask the patient? After standing or sitting At night When sneezing, coughing, or laughing When bending backwards or walking more than a few yards Patient states the pain increases with: 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. Patient states: What tests do you think the Doctor may want to order? What do you think is going on with the patient? Neuropathy - sciatic nerve; Sciatic nerve dysfunction Because sciatica is a symptom of another medical condition, the underlying cause should be identified and treated. Sciatica 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 Treatments 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 Common causes of sciatica include 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 Complications 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) Acute concerns