Preparing for your appointmentBy Mayo Clinic staff
You're likely to initially bring your symptoms to the attention of your family doctor. He or she may refer you to a doctor specializing in physical medicine and rehabilitation, orthopedic surgery, neurology or neurosurgery.
What you can do
Before your appointment, write a list that answers the following questions:
- When did you first begin experiencing symptoms?
- Were you lifting, pushing or pulling anything at the time you first felt symptoms? Were you twisting your back?
- Has the pain kept you from participating in activities you wanted to do?
- Do you have any pain that travels into your arms or legs?
- Do you feel any weakness or numbness in your arms or legs?
- Have you noticed any changes in your bowel or bladder habits?
- Does coughing, sneezing or straining for a bowel movement worsen your leg pain?
- What, if anything, seems to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
- Is the pain interfering with sleep or work?
- What medications or supplements do you take?
What to expect from your doctor
During the physical exam, your doctor may ask you to lie flat so that he or she can move your legs into various positions to help determine the cause of your pain. Your doctor may also perform a neurological exam, to check your:
- Muscle strength
- Walking ability
- Ability to feel light touches, pinpricks or vibration
- Chad DA. Disorders of nerve roots and plexuses. In: Bradley WG, et al. Neurology in Clinical Practice. 5th ed. Philadelphia, Pa.: Butterworth Heinemann Elsevier; 2008. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7506-7525-3..50117-5&isbn=978-0-7506-7525-3&sid=1063623544&type=bookPage§ionEid=4-u1.0-B978-0-7506-7525-3..50117-5--cesec12&uniqId=221226396-3#4-u1.0-B978-0-7506-7525-3..50117-5--cesec12. Accessed Oct. 5, 2010.
- Herniated disk. American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=A00334. Accessed Oct. 5, 2010.
- Herniated disc. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Herniated%20Disc.aspx. Accessed Oct. 5, 2010.
- Herniated lumbar disc. North American Spine Society. http://www.spine.org/Documents/herniated_lumbar_disc_2006.pdf. Accessed Oct. 6, 2010.
- Herniated cervical disc. North American Spine Society. http://www.spine.org/Documents/herniated_cervical_disc_2006.pdf. Accessed Oct. 6, 2010.
- JAMA patient page: Herniated lumbar disks. Journal of the American Medical Association. 2006;296:2512.
- Cauda equina syndrome. American Association of Neurological Surgeons. http://www.aans.org/Patient%20Information/Conditions%20and%20Treatments/Cauda%20Equina%20Syndrome.aspx. Accessed Oct. 6, 2010.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 6, 2010.
- Chou R, et al. Diagnosis ad treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Annals of Internal Medicine. 2007;147:478.
- Robinson J, et al. Treatment of cervical radiculopathy. http://www.uptodate.com/home/index.html. Accessed Oct. 7, 2010.
- Levin K, et al. Lumbosacral radiculopathy: Prognosis and treatment. http://www.uptodate.com/home/index.html. Accessed Oct. 7, 2010.
- Dworkin RH, et al. Pharmacologic management of neuropathic pain: Evidence-based recommendations. Pain. 2007;132:237.
- Shelerud RA (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 13, 2010.