How is sciatica diagnosed?

First, your healthcare provider will review your medical history. Next, they’ll ask about your symptoms.

During your physical exam, you will be asked to walk so your healthcare provider can see how your spine carries your weight. You may be asked to walk on your toes and heels to check the strength of your calf muscles. Your provider may also do a straight leg raise test. For this test, you’ll lie on your back with your legs straight. Your provider will slowly raise each leg and note the point at which your pain begins. This test helps pinpoint the affected nerves and determines if there is a problem with one of your disks. You will also be asked to do other stretches and motions to pinpoint pain and check muscle flexibility and strength.

Depending on what your healthcare provider discovers during your physical exam, imaging and other tests might be done. These may include:

  • Spinal X-rays to look for spinal fractures, disk problems, infections, tumors and bone spurs.
  • Magnetic resonance imaging (MRI) or computed tomography (CT) scans to see detailed images of bone and soft tissues of the back. An MRI can show pressure on a nerve, disk herniation and any arthritic condition that might be pressing on a nerve. MRIs are usually ordered to confirm the diagnosis of sciatica.
  • Nerve conduction velocity studies/electromyography to examine how well electrical impulses travel through the sciatic nerve and the response of muscles.
  • Myelogram to determine if a vertebrae or disk is causing the pain.

Last reviewed by a Cleveland Clinic medical professional on 03/25/2020.

References

  • American Academy of Orthopaedic Surgeons. Sciatica. Accessed 3/12/2020.
  • Merck Manual Professional Version. Sciatica. Accessed 3/12/2020.
  • National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Back Pain. Accessed 4/15/2020.
  • Expert knowledge and experience of healthcare providers at Cleveland Clinic.
  • Woods RP, Seamon J. Chapter 21. Arthritis & Back Pain. In: Stone C, Humphries RL. eds. CURRENT Diagnosis & Treatment Emergency Medicine, 7e. New York, NY: McGraw-Hill; 2011.
  • InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Slipped disk: Overview. 2012 Aug 14 [Updated 2017 Jun 1]. Accessed 3/12/2020.

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