-IBIS-1.5.0-
tx
musculoskeletal system
sciatica
physical medicine

exercise

• after relief of pain: strengthen gluteus medius, abdominal, lumbar muscles; stretching exercises same muscles and hamstrings (Johnson, 1946, p. 428)
• qigong: sciatica
• stretching of piriformis


hydrotherapy

• hot sitz bath
• hot fomentation: to low back and buttocks


manipulation

• first rule out disc pathology.
• DDX disc, capsulitis, piriformis syndrome, gluteal muscle referred pain, etc.
• spine: check and align L2-S1, sacro-iliac joints
• stretch:1)gluteal muscles, piriformis 2) sciatic nerve - patient on back lift and extend leg with one hand at same time bear down on ball of foot withother hand, do
gradually may be painful (Johnson, 1946, p. 427)
• lifts : 1/4 to 7/8 in lift in heel of shoe of unaffected leg, 1/16 to 3/16 in. lift under sole of affected leg (Johnson, 1946, p. 428)
• belt: to stablize SI joint
• Chapman's reflex: check and treat between ischial tuberosity and acetabulum then check and treat lateral and posterior aspect of thigh


electrical and oscillating

• diathermy: short wave use cable if available instead of condensor pad, treatment 30-45 min. daily (Johnson, 1946, p. 426)
• sine: constant current, one pad over sciatic notch other pad to sole of foot of affected leg, strength of current to produce tonic spasm of leg (to patient tolerance)
treatment for 1 min., treatment may be painful, relief is great(Johnson, 1946, p. 426)
• Galvanism: for acute sciatica large (-) pad under small of back large (+) pad under calf; treat with mild current 10 min. (Johnson, 1946, p. 427)
• TENS: for analgesia
• interferential


footnotes