Accurately diagnosing sciatica on the basis of symptoms has long been a challenge.
Dutch scientists studied a group of 395 patients with severe sciatica. The patients were asked if their pain worsened when they coughed, sneezed, or strained. The patients could choose one of four answers:
• No worsening of pain
• Worsening of back pain
• Worsening of leg pain
• Worsening of back and leg pain
At first glance, the answers didn’t seem to correspond to damage found when magnetic resonance imaging (MRI) scans were performed. But when the researchers looked specifically at one response—worsening of leg pain—they found that it was significantly associated with disc damage and nerve compression.
That finding makes sense, the researchers suggested. Coughing, sneezing, or straining puts pressure on the nerve root, which is likely to cause pain in the leg, but not the back.
If coughing, sneezing, or straining worsens leg pain, as the findings show, there’s good reason to suspect a damaged disc or compressed nerves. Providing your doctor with the location of worsening pain will help ensure you get the appropriate diagnosis and treatment.
Peter Jaret is the author of several health-related books, including “In Self-Defense: The Human Immune System” (Harcourt Brace), “Nurse: A World of Care” (Emory University Press), and “Impact: On the Frontlines of Public Health” (National Geographic). A frequent contributor to National Geographic, The New York Times, Reader’s Digest, Health, More, AARP Bulletin, and dozens of other periodicals, Jaret is the recipient of an American Medical Association award for journalism and two James Beard awards. He lives in Petaluma, Calif.