Sciatic Nerve Pain – Case Study # 1: Leila

sciatic nerve painSciatic Nerve Pain: Case Study #1 – Leila

Leila came to my office complaining of lower back pain, shooting pain from the low back and left buttocks down into the leg, pins and needles and numbness in her left leg all the way down to her toes, and severe muscle cramps behind her knee and in her calf.  Her cramps were severe at night.  She reported suddenly waking up one morning with these symptoms, and she was in a lot of pain when I saw her.  Leila is a 54 year old stay at home mom, who does daycare out of her home as well as computer related work from her home office.

Leila limped into my office, as she could barely put any weight on her left leg.  After taking the history, I proceeded with my assessment.  She had difficulty bending forwards and backwards.  Her back was painful when pressure was applied.  She had difficulty moving around and getting up, especially after being seated for a long time.  Her hamstrings were relatively flexible, although tighter on the left.  Her piriformis (a muscle deep under the gluts in the buttocks) was very tight and almost in spasm.  A large knot had developed in her calf.  Her entire leg was numb.  Twisting movements were painful to the left side.

She was experiencing acute sciatic nerve pain, and it was very debilitating for her.  Normally quite active, Leila was unable to walk to participate in any of her hobbies, such as table tennis and volleyball.

This was the second time she had experienced sciatic nerve pain.  However, this time was much more severe and did not seem to resolve quickly and on its own like her first sciatica episode a year earlier.

Anyway she continued to see me for treatment approximately twice per week, where we would work on loosening tight muscles that might have been putting pressure on her sciatic nerve, stretching, home exercises, modalities, and other techniques.  I also showed her various positions that she could lie in that would help to take the pressure off her low back and ease the sciatic nerve pains temporarily.  Unfortunately Leila has a very low pain tolerance which made it difficult for me to work the muscles as deep as I needed.

Her low back responded well to treatment, and in a few days her low back pain was gone.  However, the pain in her buttocks and all the way down the leg was still there.  As her muscles in that region were very tight, this led me to believe that her piriformis muscle was a likely compressive source of her sciatic nerve pain.

Her pain, numbness,  and night cramps continue to decrease but are still there.  Her sciatica still flares up at times and has not completely resolved.  She has had this condition for about a month and a half now, and she has lost strength in many muscles as a result.

The next step in therapy for her is to work on core strengthening and posture.