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Lumbar Radiculopathy (Sciatica)

Lumbar radiculopathy—often called sciatica—happens when a nerve root in the low back becomes irritated or compressed. It commonly causes radiating pain into the buttock, thigh, calf, or foot, and may include numbness, tingling, or weakness.

Overview Treatment Options

Common Causes

  • Lumbar disc herniation
  • Lumbar spinal stenosis
  • Foraminal narrowing (nerve exit compression)
  • Degenerative changes

Common Symptoms

  • Leg pain that travels below the knee
  • Burning, sharp, or electric pain
  • Numbness/tingling in calf or foot
  • Weakness (less common, but important)

What Is Lumbar Radiculopathy (Sciatica)?

Lumbar radiculopathy occurs when a nerve root in the lumbar spine becomes irritated or compressed. “Sciatica” is the common term patients use for radiating leg pain. True radiculopathy follows a nerve pattern and often includes numbness, tingling, or weakness—not just pain.

Bottom line: The most important step is confirming that your symptoms match the nerve level seen on imaging so treatment targets the right source.

Symptoms

Radiating Pain

  • Buttock pain traveling down the leg
  • Sharp, burning, or electric pain
  • Often worse with sitting or bending

Numbness / Tingling

  • Tingling in calf, foot, or toes
  • Numbness in a specific strip-like pattern
  • Symptoms may change with position

Weakness

  • Leg feels unstable or fatigued
  • Difficulty toe/heel walking
  • Foot drop (rare, urgent evaluation)
Urgent symptoms: new bowel/bladder changes, saddle numbness, or rapidly worsening weakness require immediate evaluation.

Common Causes

Lumbar Disc Herniation

Disc material presses on a nerve root and causes radiating leg symptoms.

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Lumbar Spinal Stenosis

Narrowing can compress nerves and reduce walking tolerance.

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Foraminal Narrowing

Narrowing at the nerve exit can cause chronic radiating symptoms.

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Leg pain can have non-spine causes too (hip issues, peripheral nerve irritation, vascular problems). The exam and imaging help narrow it down.

Diagnosis

Diagnosis combines your symptom pattern, neurologic exam, and imaging findings. The goal is to identify the level causing nerve irritation and build a plan that reduces inflammation, restores movement, and helps prevent recurrence.

History + Exam

  • Where the pain travels
  • Strength, reflex, sensation testing
  • Straight leg raise and movement triggers

Imaging

  • MRI is often most informative
  • X-rays for alignment/degeneration
  • CT in select scenarios

Confirming the Source

  • Symptoms must match imaging
  • Rule out mimics when appropriate
  • Target care to the pain generator

Non-Surgical Treatment Options

Most cases improve without surgery. Treatment focuses on calming nerve irritation, improving movement, and restoring strength so symptoms don’t keep coming back.

Physical Therapy

  • Directional preference work when indicated
  • Core + hip strength
  • Mobility and nerve glide strategies

Medication Strategies

  • Anti-inflammatory options (when appropriate)
  • Nerve pain medication options
  • Short-term symptom control plan

Activity Strategy

  • Avoid repetitive bending/twisting early
  • Walking and graded activity
  • Ergonomics + lifting mechanics

Injections

If radiating symptoms persist or limit rehab progress, a lumbar epidural steroid injection may reduce inflammation around the nerve and improve pain control. Injections are best viewed as a tool to help you move better and progress with your recovery plan—not a permanent “fix” on their own.

Lumbar Epidural Steroid Injection

When Surgery Helps

Surgery may be appropriate when imaging shows a clear source of nerve compression and symptoms persist despite appropriate non-surgical treatment, or when neurologic deficits are progressing.

Surgery May Be Considered If

  • Persistent leg pain despite treatment
  • Progressive weakness or neurologic deficit
  • Clear compressive lesion on MRI/CT
  • Significant functional limitation

Common Procedures

  • Microdiscectomy (disc herniation)
  • Decompression (stenosis)
  • Stabilization when indicated
Microdiscectomy
Emergency warning: new bowel/bladder changes, saddle numbness, or rapidly worsening weakness require immediate evaluation.

Schedule a Consultation

If you have radiating leg pain, numbness, tingling, or weakness, we can confirm the diagnosis and outline a plan based on your symptoms and imaging.

Request an Appointment

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Call 888-978-0985

FAQ

Is sciatica the same as lumbar radiculopathy?

Sciatica is a common term for radiating leg pain. Lumbar radiculopathy is the medical term for nerve root irritation in the low back that often causes sciatica symptoms.

How long does sciatica last?

It varies. Many cases improve with time and conservative treatment. Persistent symptoms may require imaging, injections, or surgery depending on severity.

When is an epidural injection recommended?

When symptoms persist despite therapy and a reasonable treatment plan, an epidural steroid injection may help reduce inflammation and improve function.

When should I worry?

Seek urgent evaluation for new bowel/bladder changes, saddle numbness, or rapidly worsening weakness.