If you told a group of well-meaning friends that you had a pain in one side of your buttocks and the back of your thigh, one might suggest that you that you have "sciatica." But do you? How do you know it's not just a pulled muscle, or bursitis or some other less nefarious condition? Even though finding the answer may require a trip to the doctor's office, there are some ways you can "test" the sciatic nerve at home.
While sitting, take a deep breath, hold it and bear down or grunt. This is called a Valsalva maneuver. This action can aggravate a damaged spinal disc. According to a July 2009 publication of the Journal of the American Medical Association, the most common cause of sciatica is a ruptured disc in the lower back. A Valsalva maneuver that causes an increase in the radiating pain is consistent with a ruptured disc scenario. Having no increase in the radiating pain suggests that the source of the pain may not be the sciatic nerve.
Lie flat on your back with your legs fully extended. Have an assistant slowly raise the straight leg on the painful side. Raising the leg places tension on the sciatic nerve. If the nerve is compressed or inflamed, it will become more painful under tension. While increased pain with this leg-raise test is not specific for sciatica, if the straight leg can be raised to 90 degrees without increasing the pain, it is unlikely that the pain is coming from the sciatic nerve. This simple test, according to a 2007 study published in the Archives of Physical Medicine and Rehabilitation, correctly identified patients with true sciatica two-thirds of the time.
Walk on your toes then walk on your heels with your toes off the floor. Is the strength of the leg on the painful side equal to that of the nonaffected side? Next, sit with your feet flat on the floor and raise the big toes off the floor. Have your assistant push down on the toes while you resist. Is there equal strength in the toes? Weakness of any of these efforts on the painful side implicates the sciatic nerve.
Close your eyes as your assistant carefully tests your ability to discern the sharp end from the dull end of a safety pin. This should be done at multiple points on both legs and feet. Reduced sensitivity over a portion of the painful leg would be expected with a significant sciatic nerve problem.
Measure the distance around the calves at their widest point. Likewise, measure the girth of each thigh at a point about 4 inches above the kneecaps. These measurements should be equal. If the painful side measures more than 1/2 inch smaller at either measurement point, this could indicate a significant sciatic nerve problem.
- Journal of the American Medical Association: Sciatica
- Archives of Physical Medicine and Rehabilitation; "The Sensitivity of the Seated Straight-Leg Raise Test...;" A. Rabin, P. Gerzsten, P. Kerausky et al; July 2007