Physio Network [Physio Explained] Is it really sciatica? A practical approach to differential diagnosis with Tom Jesson
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May 28, 2025 Tom Jesson, a physiotherapist specializing in lumbar radicular pain, shares his expertise on diagnosing sciatica. He discusses the nuances between sciatica and similar conditions like hip pain, highlighting the importance of accurate diagnosis. Jesson clarifies common misconceptions about sciatica and offers a comprehensive checklist for clinical assessment to avoid misdiagnosis. He also provides practical tips for practitioners to enhance their diagnosis skills, along with a limited-time offer for a free e-book on the subject.
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Hip Pain Mimics Sciatica
- Hip pain can sometimes mimic sciatica because it may present in the buttock or even radiate below the knee.
- This overlap can lead to misdiagnosis, especially without thorough clinical assessment.
Include Hip in Differential Diagnosis
- Always include hip-related issues such as arthritis, greater trochanter pain, and SIJ problems in your differential diagnosis for leg pain.
- Use special tests like FABER and log roll to help rule out hip origins while keeping lumbar spine stable.
Piriformis Syndrome Is Rare
- Piriformis syndrome or deep gluteal syndrome is very rare and difficult to objectively diagnose.
- Many of its supposed signs overlap with sciatica, so clear differentiation is challenging.