A detailed history will be taken with me personally, not an assistant as in many other doctors' offices. Because no two patients have the same sciatica, back or neck pain, etc, you will be asked a variey of questions about your condition, from how long you've had it, to what provokes it, its frequency, etc. I have often been complimented on my thorough evaluations. I believe it's one of the most crucial parts of determining an accurate diagonsis.
Another piece of the puzzle is the results of the examination. While pain and other related symptoms involving the back, neck, shoulders, hips, arms and legs are usually mechanical (related to muscles, joints, ligaments, discs, or nerves,) care must be taken to rule out conditions that mimic mechanical pain, known as visceral pain.
Examples are gall bladder problems that cause shoulder pain, heart attacks causing left arm pain, kidney problems causing low back pain, etc. I have been thoroughly trained to distinguish mechanical vs. referred visceral pain. Referral to the proper medical specialist for referred visceral pain will be done immediately. I have an extensive network of medical physicians such as neurologists, neurosurgeons, orthopedics surgeons and primary care doctors who I trust and recommend.
While some doctors wait before recommending x-rays, I am adamant about getting them from the start. Not only is it a simple and inexpensive diagnostic tool to help rule out serious, potentially life-threatening conditions, but it provides a detailed picture of the bones (including alignments,) joints, cartilage, and disc spaces.
Further tests such as MRI, CT scan, EMG (nerve tests,) ultrasound, and blood-work may be required to get a complete picture of your problem.