Jamie,
That is a good thought.... something else to look for tomorrow. Thanks.
Henry***
>From: [log in to unmask]
>Reply-To: - for physiotherapists in education and practice
><[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: strange case of sciatica
>Date: Wed, 6 Jun 2001 13:12:59 -0400
>
>Henry,
>Did you consider a possible peripheral entrapment. Given the anterior hip
>pain and the lack of motor involvement, you might consider a lateral
>femoral
>cutaneous entrapment. It's level (L2,3) is relatively consistent with your
>prior findings, and it's referral can be through the anterolateral hip and
>lateral thigh (to the knee). Consider entrapment at the ASIS around the
>lateral aspect of the inguinal ligament. Some researchers have suggested
>that adduction of the involved extremity can increase neural tension and
>increase the symptoms. Hope it helps. Good luck.
>James McMahon MPT, ATC
>
>-----Original Message-----
>From: Henry Tsao [mailto:[log in to unmask]]
>Sent: Wednesday, June 06, 2001 11:29 AM
>To: [log in to unmask]
>Subject: Re: strange case of sciatica
>
>
>To all:
>
>Firstly thank you for your contributions and ideas. It is always good to
>get
>another perception of the same problem, and see the different reasoning.
>
>Interesting how people have mentioned SIJ, since it is not the first joint
>I
>would look at thoroughly in the first session (apart from palpation,
>forward
>flexion and Gillet's single leg standing test which were in this case all
>normal). I will have a look at her SIJ next time as well. I always had
>thought the SIJ referred somatically to the buttock and/or posterior leg,
>but never had associated it with anterior hip pain. How does the pain refer
>anteriorly (ie, neurophysiologically)??
>
>Could it still be discal?? She is not complaining of back pain anymore, but
>the disc may perhaps be still irritating the nerve. Maybe (and this crossed
>my mind today) she may have nerve root/dural irritation at L2-L4 region,
>which may explain for why the pain is also anterior. What are people's
>thoughts on this??
>
>The other thing I am concerned with (and people have mentioned this) is the
>night pain. Unless she rolls onto that right side, this may be a redflag
>requiring further investigation.
>
>Thank you again for everyone's help, and I will keep you updated on her
>progress.
>
>Henry***
>
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