I have a new patient, 44 year old man, who has L sciatic pain, starting in his left gluteals and down his left leg upon standing or walking/running for 7 or more minutes, but all other positions or activities actually improves the pain: sitting, lying, weightlifting, biking, squatting, jump rope, sit ups, etc although it worsens after hours of sitting at work. On walks he often has to squat to get relief. Sensation is numb tingling to knife sharpness or electrical. He has had imaging diagnosing mild stenosis L5-S1 but nothing the doctors considered worth intervening for. Onset of sciatica was insidious 2 years ago with no clear initiating incident. He’s had PT for a year with no effect.

EXSTORE: He is very strong and my pressure is not that well calibrated I think, so at best I felt a little sponginess in the TFL and gluteus minimus/posterior gluteus medius. But it was unclear. He did have more restriction in SLR, about 60-70 degrees compared to 80-90 for right.

Only other thing going on is mild chronic prostatitis, no current urinary symptoms or medications.

I would appreciate some insight!