How is sciatica diagnosed?

Sciatica is a condition characterised by pain radiating along the path of the sciatic nerve, which runs from the lower back down through the hips, buttocks, and legs. It is commonly caused by a herniated disc, spinal stenosis, or nerve compression. Proper diagnosis is crucial to determine the underlying cause and guide appropriate treatment.

The diagnostic process for sciatica begins with a detailed medical history and physical examination. A doctor will ask about symptoms, their severity, and any activities that worsen or relieve the pain.

During the physical exam, the doctor may perform a straight leg raise test, where the patient lies down while the doctor lifts one leg. If this movement triggers pain along the sciatic nerve, it suggests nerve irritation. Reflexes, muscle strength, and sensation in the affected leg are also assessed to determine the extent of nerve involvement.

If further evaluation is needed, imaging tests may be recommended. X-rays help detect bone abnormalities such as arthritis or fractures, while MRI scans provide detailed images of soft tissues, including discs and nerves, making them the preferred method for identifying herniated discs or spinal stenosis.

CT scans with contrast (CT myelogram) can offer additional detail in complex cases. In some situations, nerve conduction studies and electromyography (EMG) are used to assess nerve function and detect nerve compression. A thorough diagnosis ensures the most effective treatment plan, which may include physical therapy, medication, or in severe cases, surgery.