Sciatica, a condition that affects 40% of adults at some point in life, has a well-deserved reputation for causing debilitating low back and leg pain. Richard B. Kim, MD, specializes in many treatments that ease the pain and help you stay active and healthy.
But there's only one way to heal the problem: diagnosing and treating the root cause. The first step toward healing is taking X-rays that show the exact cause of your sciatica.
Sciatica refers to the symptoms you experience when you have a pinched sciatic nerve. Near the bottom of your spine, the sciatica nerve branches off and runs down both legs.
When a problem in the spine pinches the nerve, it causes lower back pain together with sciatica's hallmark symptom: severe pain that shoots down one leg.
You may end up with sciatica after a traumatic injury. However, it most often occurs when age-related spinal degeneration causes conditions that push against the nerve.
Those conditions may include:
When it comes to diagnostic imaging to identify the root cause of your sciatica, the most important factor is whether bones or soft tissues are responsible for the pinched nerve.
X-rays have an essential role in diagnosing spine problems associated with bones. When you have an X-ray, a small amount of radiation goes through your body.
The structures in your spine absorb different amounts of radiation, depending on the tissue's density. Their density determines how they appear in the X-ray.
Bones show up as white on a standard X-ray, revealing the full scope of details, from the slightest crack to obvious fractures. By comparison, soft tissues, like muscles, ligaments, and spinal discs show up in shades of gray. As a result, X-rays seldom help us diagnose soft tissue problems.
A standard X-ray provides information that can confirm or rule out some of the underlying causes of your sciatica.
Your spinal X-ray shows:
If any of these appear on your X-ray, we have identified one cause of your sciatica, but not all the possibilities. We may need to perform other types of diagnostic imaging to find causes like a herniated disc.
A computerized axial tomography (CT or CAT) scan is a specialized type of X-ray that can show soft tissue conditions. A CT scan takes a series of X-ray images from different angles around your body.
The information goes to a computer that processes the X-rays. The computer digitally composes different angles, creating three-dimensional images of soft tissues and bones.
The images from a CT scan reveal herniated discs, the shape and size of the spinal canal (identifying spinal stenosis), and soft tissue changes such as thickened ligaments and degenerative disc disease.
A CT scan can even show problems in blood vessels, allowing us to identify vascular conditions that cause similar symptoms as sciatica. If needed, we can give you a contrast substance that highlights specific tissues and makes their details more visible.
Between standard X-rays and CT scans, we can diagnose most causes of sciatica. However, an MRI is the gold standard if we need to evaluate your spinal nerves.
MRIs don't use radiation and they don't reveal bone problems. Instead, MRIs use a magnetic field and radio waves to create detailed images of soft tissues like organs and nerves.
If you struggle with sciatica symptoms, exceptional care is available from our team at Richard B. Kim, MD. To schedule an appointment, call the nearest office — in Newport Beach or Orange, California — or use the online booking feature.