Diagnosing the Cause of Sciatica Pain

There are multiple spine conditions that can cause sciatica pain. Carefully diagnosing which of them is causing the pain will involve a complete medical history and physical examination as well as imaging studies to diagnose the exact cause of the sciatica pain.

How is Sciatica Pain Diagnosed?

Physicians will perform a series of examinations in order to properly diagnose sciatica pain. These will include a thorough history, physical and medical exam, during which a trained spine specialist will check for specific signs associated with sciatica. To arrive at a sciatica pain diagnosis, you may be asked to perform certain maneuvers designed to mimic the pain. This helps your doctor determine whether the sciatic nerve is irritated.

Sciatica Pain Diagnosis

Diagnosing sciatica requires skilled spinal expertise and a physician who has considerable experience in recognizing and treating conditions which affect the low-back. There are multiple conditions that can cause sciatica pain. Diagnosis based on a thorough analysis of the patient’s symptoms and imaging examinations is crucial to helping patients find the sciatica treatment plan that is right for their specific concerns.  Often, this requires “ruling out” certain spine conditions in order to narrow the list of potential causes of a person’s suspected sciatica pain. When it comes to accurate diagnosis, the team at BASIC investigates using every appropriate modality available until we have determined the root cause of the pain.

The History and Physical

In order to arrive precisely at a sciatica pain diagnosis, the most experienced spine experts will first conduct a complete history and physical examination. During the history portion of this evaluation, the patient is asked a series of questions regarding his or her low-back pain symptoms which often include when the pain began, whether there was an injury to the low-back or other part of the spine that caused the pain, a detailed explanation of where the pain is located and how intense it is, whether the pain radiates to the lower extremities or other parts of the body, any previous spine surgery and family history of sciatica pain.

Upon completion of this discussion, the physician will then perform a physical examination aimed at pinpointing an accurate sciatica diagnosis. The physical exam helps the doctor rule out other potential causes of the low-back pain, while honing in those that may indicate a problem with the sciatic nerve. While the low-back will be a feature of the physical exam, other parts of the body may also be examined depending on the sciatica symptoms that are being experienced by the patient.  Some of the characteristics the physician is evaluating include muscle weakness, pain that radiates into lower extremities, pain or tenderness in certain areas, sensory changes, reflex changes, motor skills and other special signs. During this physical exam, the doctor may ask the patient to walk on the heels, squat or raise one leg without bending the knee. These help in specifically diagnosing sciatica as the pain source.

MRI, CT & X-Ray

After a thorough physical and history have been conducted in order to learn more about sciatica pain symptoms, the likely next step on the path to a sciatica pain diagnosis is through an imaging study. These types of tests are usually ordered once your physician has a suspicion as to what is causing the low-back pain, based on the history questions and physical exam. Though they can’t specifically identify nerve problems, X-rays can aid in the detection of bone abnormalities that may be contributing factors involved in sciatica pain. Often, the MRI (Magnetic Resonance Imaging) is a preferred sciatica pain imaging exam because its detailed images can show any changes to the soft tissues surrounding the vertebrae. A CT scan using contrast dye can also provide useful images of the spinal cord and surrounding nerves.

Precisely diagnosing the cause of sciatica pain is crucial to the development of an effective treatment plan. While sciatica pain diagnosis may require multiple steps in order to determine exactly what’s causing the pain, it is important to seek help from a spine expert who is skilled and experienced in effectively evaluating sciatica pain and then expertly treating it using the least invasive methods first.

Sciatica Pain Diagnosis Health Tips

  • Exercise Regularly – this helps keep the spine, muscles and ligaments healthy
  • Maintain a healthy body weight – obesity or extreme weight gain can make sciatica worse
  • Wear supportive footwear – high heels and other non-supportive shoes can put unnecessary stress on the sciatic nerve
  • Sleep right – make sure your mattress isn’t too soft as this can make sciatica pain symptoms worse

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