Nursing Management of Sciatica

When seen from the nursing perspective, a scitica is acute or chronic pain starting from lower back to the knees with a throbbing-like, stabbing-like pain associated with numbness.

As per the nursing process:

1.      Assessment:

1. Impaired functionality
2. Permanent changes in physical ability

c.       Complaint of pain with walking, sitting, standing etc. 

2.      Diagnosis:

·         Impaired walking

·         Risk for activity intolerance and impaired physical mobility

• Disturbed sleep pattern
• Chronic pain

3.      Plan

1. enact non-pharmaceutical methods for treating pain
2. advise patient to consult with provider for beginning low doses of opioids 
3. relief from pain 
4. good management of pain symptoms
3. Implementation:
1. Pharmaceutical
2. Non-pharmaceutical
4. Evaluation:
1. Reduce in pain.
2. Regained mobility and physical activity.
3. No physical impairment

Interventions	Pharmaceutical	Non-pharmaceutical
Relief of pain and stiffness	Mild analgesics: NSAIDS, Tylenol Severe Pain: SHort-term use of opiods (e.g. Vicodin, Oxycotin) Procedures:  epidural coticosteroid injections, implanted devices, corrective surgery	Heat/Cold packs, alternative therpaies e.g., biofeedback, acupuncture, Yoga, stretching exercises
Pain relief and sleeping problems	Antidepressants, melatonin supplements	Drinking a wam liquid before bedtime, eg. cahmomile tea, mild etc Turning off lights/ distractors, sleeping on side with pillow between knees
Improve walking and relieving leg symptoms	Muscle relaxants: Gabapentin (Neurotonin)	Physical therapy, exercise, activity throughtout theday, resting between activities, maintinaing healthy weight, using proper body mechanics

Prevention of Sciatica 

* Regular Exercis:  Exercises that focus on lower back and abdomen-can help prevent sciatica by supporting your back. Stretching exercises can help to keep flexibility and muscle tone.

 * Maintain Posture. Good lower back support chair, armrests, and a swivel base should be used. Place a pillow or rolled towel in the back to maintain its normal curve when sitting. Working at a computer, adjust chair so that feet are flat on the floor and arms rest on the chair's arms or the desk at a 90-degree angle.

* Lifting with caution. Heavy lifting requires straight back, bend knees, and use of legs to lift. Hold the load close to body and avoid twisting and bending at the same time.

* Maintain body weight. Maintain body weight as per height (BMI) Excess weight can contribute to back problems by putting presseure on the spine.