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How Doctors Tell the Difference At Kansas Pain Management , determining the cause of leg pain involves: Detailed symptom history Physical examination (including movement and nerve tests) Imaging such as MRI (to evaluate the spine) Diagnostic injections when needed For example: If a spine injection relieves pain , the source is likely spinal (sciatica) If a muscle injection helps , piriformis syndrome may be the cause Treatment Options Treatment for Sciatica: Epidural steroid injections Nerve blocks Physical therapy Anti-inflammatory treatments Treatment for Piriformis Syndrome: Stretching and physical therapy Muscle relaxants Trigger point injections Activity modification When to See a Pain Specialist You should seek evaluation if: Pain travels down your leg Symptoms persist for more than a few weeks Sitting worsens your pain You experience numbness or weakness Treatments havent worked Early diagnosis helps prevent chronic pain and speeds recovery