Procedures for Diagnosing Sciatica

Tess Thompson

Diagnostic procedures for sciatica involve a series of processes that are required to establish the cause behind the pain. Sciatica is normally associated with compression of the sciatic nerve due to a slipped or a herniated disc. Degenerative disc disease is a condition that is brought about by the aging process. The sciatic nerve is sometimes pinched by the piriformis muscle that is located deep in the buttocks. Sciatic pain can also be caused by conditions that are not related to the disc. Bad posture can also lead to pseudo-sciatica, a pain that is similar to sciatica.

Physical examination and the medical history of the patient are very important for diagnosing sciatica. The doctor needs to eliminate normal back pain or lumbago (low back pain) before proceeding for sciatic nerve treatment. There is always a possibility that a difference in lengths of the two legs may cause pain in the lower back. Such conditions are easily corrected using heel lifts inside of the shoes.

Medical history, in most cases, is able to identify patients that are likely to have a herniated disc. Sciatic pain is superficial and localized. It also gives a feeling of numbness or tingling. It aggravates when pressure is applied between discs.

A clinical examination, more or less, confirms doubts if there are any. Physical examinations include the following procedures:

  1. The patient may be asked to lie down, face upward and the affected leg is then raised to various heights. This is done to determining the exact point of compression.
  2. The doctor may also ask the patient to rotate the hip joint. Pain caused by these movements help in pinpointing the location of the pain and assessing the hip muscles.
  3. Testing the strength of the ankles and toes while bending backward can also indicate the position where the nerve is likely to be pinched. A weakness in bending backwards indicates an L-5 dysfunction.
  4. Testing reflexes of ankles assesses S-1 root function.

Symptoms like disability in walking suggest nerve root compression. In cases where symptoms are severe enough to consider a surgical intervention, the physical examination is mostly followed by other investigative procedures. To confirm any doubts, the physician might ask for these tests to be completed:

  1. X-rays
  2. Magnetic Resonance Imaging (MRI)
  3. Computed Tomography (CT) Scan
  4. Electromyography (Electric current is passed through a nerve to record the electrical waves associated with the activity of skeletal muscles)
  5. Myelography (X-rays taken after injecting a contrast dye into the space between vertebrae)

Diagnosing sciatica is a complex procedure. Since the pain can be indicative of other conditions as well, it is also necessary to rule out more serious conditions like infection or cancer. Sciatica is a progressive disease that can immobilize the patient to a great extent. Sciatica alternative remedies like exercises, chiropractic manipulations, yoga and acupuncture can be very effective to stem the progress of a highly developmental condition. On the first signs of pain in the lower back, examination by a specialist is highly recommended.


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