Nerve Stretch, Leg Pain, Other Tests For a Pinched Nerve

KatherineH45 Asked :

My problem started 6 months ago when both of my legs started paining but the left leg pain was worse. The right ankle became quite sore and started swelling bout a month later and I visited my doctor who told me that I was putting too much pressure on the leg. He suspected that I had a pinched nerve and sent me for x-rays but told me that everything was clear. I tried walking equally on both legs despite the pain and it has been on and off like this for all this time. I figured that it was just a matter of getting old because I am 54 years old now and I have also had lower back pain for years. The swelling went down about a month later.

Last week I decided to start yoga because I heard that it can help with leg pain and experienced severe discomfort while doing basic positions. The yoga teacher tried to assist me with the stretching and told me that people with pinched nerves often experience pain in some of these positions. My x-rays were clear and I do not want to seem like a hypochondriac by constantly going back to my doctor for something like this. What other tests can be done to detect if it is a pinched nerve? Which nerves may be pinched?

This question was posted under the Pinched Lumbar Nerve article.

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Dr. Chris Answered :

Since there were no abnormalities detected on the x-rays, an MRI should have been considered. Your condition may have been in the early stages at the time and therefore there was no clear indication of it on the x-rays. There are nerve stretch tests which can help to identify nerve root compression and this can be done by your doctor during the physical examination. However, this is only done to detect any compression of the nerve root and other tests like an MRI, nerve conduction study and/or electromyography are still necessary to identify the cause.

It is difficult to isolate exactly which nerves are affected but from what you describe, the sciatic nerve and femoral nerve are the most likely cause.  Your yoga positions may have been similar to the nerve stretch tests that are conducted by a doctor to identify nerve root compression.

If you were lying flat on your abdomen with your face down (prone) and bent the leg at the knee (knee flexion), you may have experienced pain from the lower back to the knee. This is similar to the femoral nerve stretch test and indicates root compression at the level of L2, L3 and/or L4. If you were lying on your back (supine) and experienced pain upon raising your leg which is also exacerbated by moving the foot in this position (specifically dorsiflexion of the foot), then this may indicate compression of the sciatic nerve (L4 to S3). This is known as the straight leg raise.

Speak to your doctor about your condition and your recent experience. Aging should not be associated with pain. It is better to be safe than sorry and identify the cause as soon as possible even if it means going back to your doctor many times. Depending on the cause of the pain, there can be more serious complications with time if you leave the condition unattended.

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