During the physical exam, your doctor may check your muscle strength and reflexes. For example, you may be asked to walk on your toes or heels, rise from a squatting position and, while lying on your back, lift your legs one at a time straight in the air. Pain that results from sciatica will usually become worse during these activities.
Many people have herniated disks or bone spurs that will show up on X-rays and other imaging tests but cause no symptoms. So doctors don't typically order these types of tests unless your pain is very severe or it doesn't improve within a few weeks.
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- X-ray. An X-ray of your spine may reveal an overgrowth of bone (bone spur) that may be pressing on a nerve.
- Magnetic resonance imaging (MRI). This procedure uses a powerful magnet and radio waves to produce cross-sectional images of your back. MRI produces detailed images of bone and soft tissues such as herniated disks. During the test, you lie on a movable table inside the MRI machine.
- Computerized tomography (CT) scan. When CT is used to image the spine, you may have a contrast dye injected into your spinal canal before the X-rays are taken — a procedure called a CT myelogram. The dye then circulates around your spinal cord and spinal nerves, which appear white on the scan.
- Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth-Heinemann Elsevier; 2008. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-7506-7525-3..X5001-8--TOP&isbn=978-0-7506-7525-3&uniqId=230100505-57. Accessed Aug. 2, 2012.
- Frontera WR, et al. Essentials of Physical Medicine and Rehabilitation: Musculoskeletal Disorders, Pain, and Rehabilitation. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/208746819-6/0/1678/0.html. Accessed Aug. 2, 2012.
- Hsu PS, et al. Lumbosacral radiculopathy: Pathophysiology, clinical features and diagnosis. http://www.uptodate.com/index. Accessed Aug. 2, 2012.
- Levin K, et al. Acute lumbosacral radiculopathy: Prognosis and treatment. http://www.uptodate.com/index. Accessed Aug. 2, 2012.
- Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-323-05472-0..X0001-1--TOP&isbn=978-0-323-05472-0&uniqId=230100505-57. Accessed Aug. 2, 2012.
- Barbara Woodward Lips Patient Education Center. Radiculopathy. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2003.
- Knight CL, et al. Treatment of acute low back pain. http://www.uptodate.com/index. Accessed Aug. 9, 2012.
- Acupuncture for pain. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/acupuncture/acupuncture-for-pain.htm. Accessed Aug. 9, 2012.
- Shekelle P. Spinal manipulation in the treatment of musculoskeletal pain. http://www.uptodate.com/index. Accessed Aug. 9, 2012.