Lumbosacral radicular syndrome (sciatica)

Overview

Lumbosacral radicular syndrome - often called sciatica - is pain radiating down the leg in the distribution of a lumbar or sacral nerve root, frequently caused by a disc herniation. Pain is typically worse than the back symptoms and may be accompanied by altered sensation or weakness in the affected leg.

Symptoms

• Sharp, shooting or burning pain down the leg
• Pins and needles or numbness in a specific dermatome
• Pain provoked by coughing, sneezing or sitting
• Possible weakness in the foot or ankle

Causes

• Lumbar disc herniation pressing on a nerve root
• Foraminal narrowing from degenerative change
• Inflammation around the nerve root

Treatment

• Education and pain management in the acute phase
• Nerve mobility and graded activity as symptoms allow
• Progressive strengthening once leg pain centralises
• Referral for imaging or specialist review if red flags or progressive weakness appear