How to Test if You Have Sciatica

Sciatica is not your typical lower back pain. It carries rare and painful symptoms, extending even below the back, and it may be startling to anyone who’s never experienced it before.

As frustrating as sciatica pain is, it almost always resolves on its own. However, effectively treating sciatica requires proper diagnosis.

In this article, we will discuss what defines sciatica as well as how to test if you have it.

What Is Sciatica? 

Sciatica is lower back pain that radiates through the back of the leg, past the knee, and sometimes into the big toe. In most instances, sciatica only affects one side of the body and has the following symptoms: tingling, numbness, sharp pain, burning sensations. In severe cases of sciatica, you may even experience leg weakness and loss of bladder or bowel control.

“Sciatica is also very common and almost everyone will experience symptoms at least once in their lifetime,” says Dr. Bhavik Sheth, Physical Therapist and co-founder of Elite Movement Initiative.

This type of pain occurs when one or more nerve roots in our lower lumbar spine (low back) or sacrum (bottom portion of the spine) become compressed. You can “pinch” a nerve doing repetitive activities that place a lot of stress on your spine, such as heavy lifting and frequently sitting up and down. Poor posture can even exasperate sciatica pain, too.

It’s worth mentioning, the sciatica nerve can also become pinched in other areas of the body. Given its length, your sciatica nerve may become compressed in your buttock or lower leg. When this occurs, it is not considered sciatica because the pain point is not located in the lower back region, and compressed nerves in other parts of the body will require different treatment.

 “This condition is called Piriformis Syndrome, which has similar symptoms as sciatica, however the source of the nerve compression is in the buttocks,” says Dr. Bhavik Sheth.

SEE ALSO: Best Mattress for Sciatica

Sciatica Tests

Medical professionals primarily use two tests to determine whether or not their patients have sciatica: the straight leg raise and slump test.

These diagnostic tests also assist doctors and physical therapists in locating the specific pinched spinal nerve, and this can help in determining the cause of sciatica pain. Therefore, visiting your doctor may be the best way to diagnose your pain, but if you want to be sure, you can easily perform both physical exams at home. Here’s how.

Straight Leg Raise Test

The straight leg raise test requires the sciatic nerve to extend. If you have sciatica, this exercise will irritate the nerve and cause your pain to flare up.

1. Lie on a solid surface in the supine position (on your back with both legs extended).
2. Slowly lift one leg approximately 30 to 70 degrees. Focus on keeping your buttock and hamstring muscles relaxed.
3. Repeat step two for your other leg.

If your pain worsens and extends below the knee while performing this activity, it’s considered a positive test. However, if you only experienced pain in your lower back or gluteal region, your symptoms may be the result of another injury or tight muscles.

Slump Test

The slump test requires you to sit with bad posture since this places excess pressure on the nerve roots of your lower back. If you have sciatica, this test will briefly intensify your symptoms.

1. Sit on a chair that does not support your back and allows your legs to hang.
2. Clasp your hands behind your back.
3. Slump your shoulder and curve your back. Put simply, display improper posture.
4. Tuck your chin into your chest.
5. Extend one knee as far as possible.
6. If you find this painful, dorsiflex your ankle. Dorsiflexing requires you to forcefully point the surface of your foot toward your body without the assistance of your hand.
7. If you also find this painful, further extend or stiffen your knee. From here look up to the ceiling while maintaining your back posture. 

If your symptoms improve from looking up with your leg extended it’s a positive test result.

While the straight leg raise and slump test are the most accurate way to identify sciatica, you may be able to rule out sciatica by forcefully massaging your back muscles. If vigorously massaging the muscles aggravates your pain, you most likely have an injured muscle, not pinched nerve roots.

Sciatica is often the symptom of an underlying injury. Therefore, severe pain lasting longer than 8 weeks may move a medical professional to conduct a series of X-rays, computed tomography scans, magnetic resonance imaging studies, or electromyography. These in-depth diagnostic tests will give your healthcare provider a closer look at the bones and soft tissues near the affected area.

Common Causes of Sciatica

As mentioned earlier, sciatica is the result of one or more compressed nerve roots in the lumbar or sacral region, but what causes these nerve roots to compress?

Lumbar spinal stenosis, or narrowing of space in your lumbar spine, causes structures in your low back to touch, sometimes placing pressure on the spinal nerves. Although some people are born with spinal stenosis, it is typically the result of aging. Mattresses for spinal stenosis should offer a balance of support and pressure relief.

Herniated Discs

Herniated spinal discs are the most frequent cause of sciatica. Spinal discs are gel-like cushions resting between each bone in our spine. They act as a shock absorber, bearing the brunt of impact while guarding the spinal nerve column.

Over time, the material of our spinal discs deteriorates and causes the discs to slip slightly from their intended spot. The slipped disc often makes contact with nearby structures such as the nerves. When discs touch spinal nerves they irritate or place pressure on them, resulting in painful symptoms of sciatica.

SEE ALSO: Best Mattress for Herniated Disc (2021): Reviews and Buyer’s Guide

Bone Spurs

Bone spurs typically occur with joint injury or degeneration. When your cartilage is compromised, additional bone forms in its place. This is your body’s attempt to preserve and protect the area. Like herniated discs, bony growths can irritate or strain nearby nerves and cause sciatica pain.

Sciatica symptoms like sharp lower back pain, leg pain, hip pain, tingling, and numbness are sometimes mimicked by other injuries. While the symptoms caused by different injuries can be similar, they are not the result of constricted nerve roots in the spine, and thus, technically not sciatica.

Other Injuries That Cause Sciatica-Like Symptoms

Piriformis Syndrome

Piriformis syndrome occurs when the piriformis muscle is tight. The piriformis muscle is located in the buttock, near the hip joints, and heavily assists lateral rotation of the hip. The muscle becomes compromised from overuse such as long-distance running, inclined running or walking, and lunging.

When this gluteus muscle is injured, it tends to spasm and place pressure on the sciatic nerve, resulting in sciatica-like symptoms. However, the pain emerges from the buttock rather than the spine, so it is not considered sciatica and requires unique treatment.

Sacroiliac Joint Dysfunction

Sacroiliac joint (SI joint) dysfunction happens when the joint connecting the pelvis to the sacrum degenerates or becomes injured. The SI joint’s main function is to distribute and transfer weight from the upper body to the lower body. Age, giving birth, car accidents, and falls can jeopardize the joint.

Patients with an injured SI joint experience hip and groin pain, leg pain, numbness, and weakness. While similar to sciatica pain, it is the result of improperly moving pelvic joints rather than compressed spinal nerves. Therefore, the treatment will significantly differ from sciatica-related injuries.

It is important to determine if you have true sciatica because treatment is dependent upon injury. In fact, incorrect treatment may worsen your symptoms. If you experience sciatic-like pain, we suggest reaching out to your doctor or physical therapist.

Treatment of Sciatica

If you have true sciatica, your healthcare provider will more than likely provide you with a conservative treatment plan focused on pain management and physical activity with a physical therapist. However, chronic or severe cases may require more invasive measures like steroid injection or spinal surgery in addition to physical therapy. Let’s go over the purpose of each.

• “You may be referred to a physical therapist who will provide you with purposeful stretches meant to strengthen the spine-supporting muscles, facilitate good posture, and increase back flexibility,” says Dr. Bhavik Sheth. These at-home stretches will reduce any muscle spasms accompanying your sciatica while encouraging a healthy spinal movement.
• Low-impact exercise, such as walking, can relieve sciatica pain. Walking produces pain-fighting endorphins while increasing breathing rate, blood pressure, and heart rate to reduce irritating inflammation. To fully benefit from walking, be sure to keep a comfortable pace and proper posture while engaging your core.
• Steroid injections are given to patients with debilitating pain with neurological symptoms. Steroid injections are epidural shots inserted into the affected area to quickly reduce irritating inflammation. They give the patient time to heal their injury with conservative care while experiencing little to no pain.
• Spinal surgery is used as a last resort for rare cases of sciatica. It typically consists of an orthopedic surgery removing the excess bone or disc material causing spinal nerve pain.

FAQ

Will I have sciatica for the rest of my life?

Depending on the treatability of your injury, sciatica may last longer than 8 weeks, classifying it as chronic. Chronic sciatica typically results in episodes recurring throughout the patient’s life. However, chronic sciatica tends to be much less painful than acute.

This is because those who frequently experience this type of lower back pain take measures to reduce sciatic pain. These measures may consist of lifestyle changes such as routine exercise, daily stretching, maintaining good posture, using a lumbar roll while sitting, avoiding inflammatory foods, and investing in a mattress for back pain.

Is sciatica a serious condition?

Sciatica is not a condition, but a symptom of lower back impairments. Most sciatica-related injuries resolve on their own with conservative treatment. However, rare cases may result in permanent nerve root damage. If you experience notable leg weakness or lose control of your bladder and bowel, you should reach out to your doctor immediately. These severe symptoms often require the attention of a specialist and sometimes, surgical intervention.

Is massage good for sciatica?

Sciatica symptoms arise from nerve-related injuries, and massage is used to treat muscle trauma. While massage therapy will not cure your sciatica, it may help. Oftentimes, sciatica causes the lower back muscles to tighten and spasm. Therefore, a massage therapist may be able to loosen them and alleviate some pain.

What should I avoid with sciatica?

Activities placing excessive pressure on your lower back will further compress the irritated nerve roots and intensify your sciatica symptoms. To prevent this, avoid prolonged sitting, heavy lifting, intense physical activity, and bad static postures. Although coughing and sneezing are sometimes out of our control, it can also strain the lower spine and cause a quick eruption in pain.

Can certain foods make sciatica pain worse?

Sciatica related injuries lead to swelling around the restricted nerve roots. Since saturated fats are known to cause inflammation, they will intensify the pain. Until your sciatica has subsided, refrain from eating or drinking anything fried, processed, dairy-based, or containing red meat. Instead stick to an anti-inflammatory diet of fruits, vegetables, fish, grains like oatmeal and brown rice, beans, green tea, and fresh herbs and spices such as garlic and turmeric.

Conclusion

Determining the exact cause of your lower back pain is crucial to finding an effective treatment. Sciatica tends to carry a wide range of symptoms. Therefore, injuries that take place near the sciatic nerve are often misdiagnosed as sciatica-related trauma. It goes without saying, the treatment suggested for sciatica may be less than beneficial to anything else.

If you think you have sciatica, we suggest completing the above tests at-home, and regardless of the outcome, consider seeking the advice of your healthcare provider. They will be able to create an individualized treatment plan fit to meet your needs.