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  • Lumbosacral radicular syndrome

  • 355.0 Lesion of sciatic nerve
  • 722.73 Intervertebral disc disorder with myelopathy, lumbar region
  • 724.3 Sciatica
  • 724.4 Thoracic or lumbosacral neuritis or radiculitis, unspecified

  • G57.00 Lesion of sciatic nerve, unspecified lower limb
  • M54.16 Radiculopathy, lumbar region
  • M54.17 Radiculopathy, lumbosacral region
  • M54.3 Sciatica


  • Low back pain radiating into the lower extremity (LE)
  • Can result from lateral lumbar/sacral spine nerve root compression or piriformis syndrome

Essentials of Diagnosis

  • Diagnosis made by clinical examination
  • Dermatome/myotome pattern compared to peripheral nerve distribution
  • Reproduction of symptoms

General Considerations

  • Presence of leg pain significantly increases the odds of condition becoming persistent


  • Nonspecific
  • Most individuals will have sciatica symptoms at least once in their lifetime

Signs and Symptoms

  • Pain radiating down the leg(s), below the knee, along the distribution of the sciatic nerve
  • Usually related to mechanical pressure and/or inflammation of lumbosacral nerve roots
  • Can be with or without lower back pain
  • Diminished sensation, motor control, and reflexes in the distribution of the involved nerve

Functional Implications

  • Difficulty maintaining sustained sitting postures secondary to back and leg pain
  • Inability to sleep
  • Weakness with lifting, prolonged standing
  • Loss of movement or feeling in the LE
  • Difficulty with movements secondary to pain such as driving or twisting

Possible Contributing Causes

  • Postural changes including weakness of core musculature and tightness of hip flexors, external rotators, and hamstrings
  • Prolonged occupational stresses
  • Pregnancy
  • Disc pathology, other sources of nerve root compression
  • Smoking

Differential Diagnosis

  • Peripheral nerve impairment
  • Hip pathology with radiating pain pattern
  • Spinal tumor
  • Lyme disease
  • Peripheral neuropathy
  • Paraspinal muscle hypertonicity
  • Degenerative disk disease
  • Sacral or pelvis dysfunction


  • MRI helpful in diagnosis to visualize compressed or inflamed nerve root
  • X-ray/plain film radiograph helpful if osteophyte located in intervertebral foramen
  • CT scan to show herniation compressing the spinal canal/nerves
  • Electrodiagnostic/nerve conduction testing can assist to determine a specific impaired nerve function

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