Physio Network [Case Studies] Breaking down sciatica: a case study discussion with Charlie Clements
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Apr 16, 2025 In this discussion, Charlie Clements, a First Contact Physiotherapist with expertise in spinal pathologies, shares his insights on sciatica management. He breaks down key diagnostic techniques and highlights the importance of distinguishing sciatica from similar conditions. Charlie emphasizes personalized treatment options and collaborative strategies between patients and clinicians. He also delves into effective referral processes when conservative treatments don’t yield results, making complex concepts accessible to healthcare professionals.
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Case Introduction by Charlie
- Charlie Clements treated a middle-aged man suspected of sciatica who had significant discomfort and failed self-management.
- He serves as a first contact physiotherapist, providing assessments and coordinating further investigations or referrals.
Key Diagnostic Features of Sciatica
- Diagnosis of sciatica can be guided by five features increasing confidence in its presence.
- These include leg pain worse than back pain, pain below the knee, sensory changes, neurological deficits, and positive neurodynamic test.
Differentials Masquerading as Sciatica
- Somatic referred leg pain and hip arthritis can mimic sciatica but have distinguishable characteristics.
- Differences include pain quality, location, severity, and specific physical exam findings to clarify diagnosis.