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Sciatica Pain Assessment:
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What is Sacroiliitis or SIJD and how does it affect the symptoms?
It is critical to find out if there has been a history of Sacroiliitis – Sacroiliac pain also known as Sacroiliac Joint Dysfunction (SIJD), because it can mimic some Sciatica symptoms. Find out what movements exacerbate or decrease pain, if the pain is continuous or intermittent, and what time of day the pain is at its worst and what has or has not been done to decrease pain, as well as pain scale levels.Are there any Visual Symptoms I can expect to see, and what can I do to reveal them?
Observation of the affected area will not normally reveal anything remarkable, however, a Gait Analysis will reveal the severity of the problem if one leg is favored over the other, and if the person walks with a limp or not. A Postural Analysis is also important, because it will also reveal if one leg is favored over the other, as the unaffected leg will afford greater weight bearing, and if the person will have difficulty standing in one place for long periods of time.If one of the feet are pointed outward, does that mean something?
If the person stands with one foot pointed outwards, ask if that is the affected side. If the affected side has the foot pointed outward, it is probable that the femur is externally rotated. You can find out if the femur is externally rotated with the person lying prone-face down, or supine-face up during range of motion testing. External femur rotation is a possible indication of a contracted Piriformis Muscle, because the job of the Piriformis muscle is to externally rotate the femur.What should the affected areas feel like when palpated?
The Palpation part of the Sciatica Pain Assessment-evaluation of tissue by feel of the affected area should reveal increased pain, tenderness on the affected side of the lower back, buttocks, and hamstrings. Check to see if Trigger Points are present in the soft tissue structures. Check for individual temperature, tone, pain and tenderness of each specific location. Increased temperature indicates possible inflammation; decreased temperature could indicate poor circulation.What should the muscle tissues feel like?
Muscle tissues should be supple, because hypertonicity or flaccid tissues indicate possible circulatory or nerve related problems. Place moderate pressure upon different locations along the nerve pathway to see if Radicular pain can be duplicated to find the possible location of the Radiculitis, especially where the Piriformis muscle is, to possibly rule out Piriformis Syndrome. Sciatic nerve entrapment can also occur at the Biceps Femoris or Obturator Internus.What Sciatica Pain Assessment Range of Motion Tests should I be doing?
Active(AROM), Passive(PROM), as well as Resisted Range of Motion(RROM) Testing for the Sciatica Pain Assessment should be conducted to determine the movements that exacerbate pain. If the Piriformis muscle is contracted or hypertonic, then you should anticipate that range of motion testing will show excessive external rotation with decreased internal rotation.What does decreased PROM indicate?
Significantly decreased passive range of motion for internal leg rotation of the affected side is indicative of a hypertonic Piriformis muscle which could mean that Piriformis Syndrome is present.Are there other special tests should that should be conducted?
There are 3 special diagnostics tests for the Sciatica Pain Assessment that could be made to check lower lumbar nerve impingement or sacral nerve impingement. Make sure to at least perform the Straight Leg Raise Test to define L5 /S1 sciatic nerve root activity. |
Don’t forget to check for Leg Length discrepancies and check the SI Joints also
Sciatica Pain Assessment Testing should also be conducted to determine if a leg length difference exists as a contributor or exacerbation component of sciatic pain. Sacroiliitis – Sacroiliac pain also known as Sacroiliac Joint Dysfunction (SIJD) can mimic some Sciatica symptoms, so we must test the Sacroiliac joints of both the unaffected side and the affected side to rule them out, because SIJD often cannot be revealed with imaging diagnostics.What other Hip Components contribute to the root of the problem?
We must also not forget to check for Hip rotation or Hip elevation as indirect Sciatic Pain components because Hip rotation can cause Hyperlordosis or Hypolordosis which can in turn cause a herniated disc or a ruptured disc or Spondylosis- Spinal Vertebra Osteoarthritis, or Spondylolisthesis – Anterior Vertebra Displacement, or Degenerative Disc Disease.Please click on the links below for more information!
Sciatica Treatment What are my options?
Return to Sciatica from Sciatica Pain Assessment Irritation-Impingement-Compression-Entrapment of the Sciatic Nerve
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