How To Diagnose Sciatica

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Sciatic nerve pain can come from multiple different sources. The most effective exercises and treatment for sciatica can vary greatly depending on where your nerve pain is originating. In this video, I'm sharing some simple signs and tests you can do at home to diagnose the problem behind your sciatic nerve symptoms in order to treat it as effectively as possible.

Important time stamps in this video:
Relevant anatomy: 0:25
How to diagnose a bulged/herniated disc: 2:54
How to diagnose degenerative disc disease/DDD/stenosis: 8:31
How to diagnose piriformis syndrome: 10:17

HOW TO TREAT SCIATICA FROM BULGED/HERNIATED DISC: https://youtu.be/fDkw-Zi5MBg

HOW TO TREAT SCIATICA FROM DDD/DEGENERATED DISC/ STENOSIS: https://youtu.be/bgY7uWPOlRA

HOW TO TREAT SCIATICA FROM PIRIFORMIS SYNDROME: https://youtu.be/5ZXJEO6fc-4

***The information presented in this video is for informational purposes only and is, in no way, meant to be used as personal or individual treatment recommendations. I would ALWAYS encourage you to go get assessed by a local doctor or physical therapist for a treatment plan that is best for your specific needs.

Sciatic nerve pain, or “sciatica“, is characterized as pain, numbness, or tingling that usually originates in the lower back and travels down one or both legs. As a doctor of physical therapy, this is one of the most common conditions that I treat in my clinic.

It is crucial to note, however, that “sciatica“ by itself is simply a SYMPTOM, and not a complete DIAGNOSIS. That means that “sciatica“ describes this pain/numbness/tingling down your leg, but does nothing to explain the CAUSE of these symptoms.

Here’s the thing – in order to most effectively treat your sciatic nerve pain symptoms, you have to treat the CAUSE of the pain and not just the SYMPTOM itself. It’s crucial that you uncover the specific origin of your sciatica in order to determine the most effective plan of care for your treatment.

The three most-common causes of sciatic nerve pain that I see as a physical therapist are:

1. Herniated/bulged lumbar disc
2. Degenerative disc disease/DDD/stenosis
3. Piriformis Syndrome

All three of these conditions can cause stress/irritation to the sciatic nerve which, in turn, can lead to sciatica symptoms down your leg.

Some of the most common signs and symptoms associated with a BULGED/HERNIATED DISC include:
- Symptoms are unilateral (one-sided)
- Sciatic symptoms can travel all the way to the foot
- Can be pain, numbness, or tingling
- Sciatic symptoms aggravated with forward bending
- Symptoms typically alleviated or made better with standing/walking

To test for a bulged/herniated disc at home:
- Slump test
- Straight leg raise test
- Decreased muscle activation and activity

HOME EXERCISES TO TREAT A HERNIATED/BULGED LUMBAR DISC: https://youtu.be/fDkw-Zi5MBg

Some of the most common signs and symptoms associated with DEGENERATIVE DISC DISEASE/DDD/STENSOSIS include:
- Older age (over 40 years old)
- Sciatica symptoms increased with standing/extension
- Sciatic nerve symptoms alleviated with sitting/flexion
- Sitting is preferred to standing
- Sciatic symptoms can happen bilaterally (down both legs)

HOME EXERCISES TO TREAT LUMBAR DDD / STENOSIS: https://youtu.be/bgY7uWPOlRA

Some of the most common signs and symptoms associated with PIRIFORMIS SYNDROME include:
- Aggravated with sitting (pressure on the nerve; can be increased with sitting on a wallet)
- Decreased hip mobility (decreased rotation range of motion)
- Pain with muscle activation (specifically piriformis muscle contraction)

To test for a piriformis syndrome condition at home:
- Check hip mobility
- Perform a resisted muscle activation for the piriformis

HOW TO TREAT PIRIFORMIS SYNDROME: https://youtu.be/5ZXJEO6fc-4

Properly diagnosing your sciatic nerve pain can make all the difference in effectively treating this pain/irritation and providing you with some relief to these symptoms.

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