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Ischias (radiculopathia lumbosacralis) · Ischias

What it is

A disc or bone spur presses a lumbar root; pain shoots down the leg.

Symptoms & signs

  • Shooting buttock-to-calf pain
  • numbness
  • weak foot
  • worse on coughing

🚩 Get help if…

  • call 112 / 911 now Numbness around the bottom or genitals, or loss of bladder or bowel control
  • call 112 / 911 now Weakness in both legs
  • see a doctor soon Foot drop or leg weakness getting worse
  • see a doctor soon Back pain with fever, weight loss or a past cancer

Where it strikes

Medical treatment

  • NSAIDs
  • physiotherapy
  • epidural steroid injection
  • microdiscectomy if weakness or no improvement
  • annular closure device after discectomy (Barricaid) — FDA-approved 2019 for large annular defects

Natural & lifestyle

  • Stay active — bed rest makes it worse
  • McKenzie extension exercises
  • heat
  • core strengthening
  • weight loss

Emerging & experimental

  • Platelet-rich plasma injections
  • condoliase chemonucleolysis

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Acupuncture — trials disagree mixed evidence
  • Spinal manipulation — modest short-term benefit in trials mixed evidence
  • Inversion tables — little evidence early / small studies
  • Copper and magnetic bracelets — trials found no effect not confirmed in trials

ICD codes