An L5 radiculopathy causes pain that radiates from the buttock down the leg to the outside of the ankle and into the top of the foot toward the big toe. Each has a specific distribution of the pain, numbness and weakness. The two most common nerve roots that are affected are the fifth lumbar (L5) and the first sacral (S1) roots. This is referred to as cauda equina syndrome and is considered a true emergency and requires immediate investigation and treatment. In severe cases the bladder or bowel can also be affected. The distribution of the pain, numbness and weakness can help identify which nerve root is being irritated. However most people only experience pain with no or little numbness and no weakness. If the nerve root is severely compressed people can also experience weakness in one or more muscles in the leg. In addition to the leg pain, clients can experience numbness in part of the leg. Coughing, sneezing or straining while going to the bathroom often makes the pain worse. Lying down with the knees bent can improve the pain. Straightening the affected leg will often make the pain worse. However the leg pain is usually much worse than the back pain. In some people they experience back pain for hours or days before the onset of the leg pain. Pain killers are often prescribed but usually do not provide complete relief of the pain. Clients often have trouble finding a position which will improve the pain. In some cases there is a specific cause such as heavy lifting, a fall or a motor vehicle accident. However in many cases there is no specific injury that can be attributed to the onset of the pain. The onset of pain is often sudden and may be related to a specific event such as bending and twisting of the spine. The major symptom is pain which can be excruciating.

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