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Diagnosis of sciatica starts with a good clinical history and a good detailed physical examination. Sciatica usually presents with pain that goes down the leg, usually starting in the buttock into the back or the side of the thigh, into the leg and occasionally into the foot, and associated with some numbness and tingling in the same distribution as well. The physical examination for somebody who’s complaining of sciatica symptoms should include a detailed strength exam of the leg, as well as some reflexes in the leg. Once somebody has a diagnosis of sciatica established, there are imaging studies that need to be obtained in order to identify the cause of the sciatica. That usually starts with some plain x-rays of the lumbar spine, and then with an MRI of the lumbar spine that shows the nerves and the discs in detail.
