Sciatica - Lumbosciatalgia

Very low urgency
Very common-

It is a pathology that appears when the sciatic nerve, which originates in the lower spine (L4, L5, S1 and S2), is lesioned at some point along its course.

The most frequent cause is the herniation of an intervertebral disc. 

It manifests with low back pain that extends to the buttock, back of the leg and dorsum of the foot.

It is usually described as an intense stabbing pain that is aggravated by walking, sitting, coughing, defecation and compression of the point of the spine where the lesion has occurred.  

The diagnosis is made through clinical history and complete physical examination. It is confirmed by imaging tests that reveal herniation of the intervertebral disc.

The priority of treatment is to relieve pain with analgesics and anti-inflammatory drugs, and absolute rest is not necessary. Physiotherapy sessions may be beneficial. In some cases, surgical treatment will be necessary. 

Bibliographic references
  1. E. Tolosa. Neuropatías secundarias a atrapamiento, compresión u otros agentes físicos. Farreras Rozman. Medicina Interna. Volumen II. Duodécima edición. 1489:1491.
  2. Maria Elena piqueras Moya, Francisco Javier Lucas Imbernón, David Caldevilla Bernardo. Lumbalgia. Manual de protocolos y actuación en urgencias. Hospital Virgen de la Salud, Complejo Hospitalario de Toledo. Tercera edición. 2010.1087:1090.
  3. John J. Cush. Valoración de los trastornos articulares y musculoesqueléticos. Harrison. Principios de Medicina Interna. Volumen 2. 19ª Edición. 2222:2225.
  4. Kerry Levin, Philip S Hsu, Carmel Armon. Acute lumbosacral radiculopathy: Treatment and prognosis. UpToDate. Jun 14, 2016.
  5. Philip S Hsu, Carmel Armon, Kerry Levin. Acute lumbosacral radiculopathy: Pathophysiology, clinical features, and diagnosis. UpToDate. Jan 11, 2016.
  6. Tarulli AW, Raynor EM. Lumbosacral radiculopathy. Neurol Clin 2007; 25:387.
  7. Deyo RA, Weinstein JN. Low back pain. N Engl J Med 2001; 344:363.
  8. Bogduk N. The lumbar disc and low back pain. Neurosurg Clin N Am 1991; 2:791.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Lower back pain


    Back pain down the back of the thigh to the foot


    Lower back pain down the side of the leg to the foot


    Sharp pain in the buttock and back of the leg


    Pain improves when reclining

Symptoms to watch out for

Loss of sensation in the affected leg
Inability to move the affected leg
Weakness in the affected leg

Self-care

Get regular physical activity at least 3 times a week that is appropriate for your age and physical condition.
Place a pillow or rolled-up towel in the curve of the lower back to maintain a normal curvature of the spine when sitting.
Lose weight if you are overweight or obese.
Squat with your back straight and bend your knees.