The most commonly occurring fifth lumbar radiculopathy causes lateral and anterior thigh and leg pain. Often, accompanying numbness or tingling occurs with a similar distribution to the pain distribution. Accompanying muscle weakness may go unrecognized if the pain is incapacitating. The pain usually improves when the patient is in the supine position with the legs slightly elevated. Patients are more comfortable when changing positions.
Short walks can bring relief.
On examination, patients may be neurologically normal, may have a profound radiculopathy, or may even demonstrate a cauda equina syndrome. A positive straight-leg raising sign is almost always present. However, a crossed straight-leg raising sign may be even more predictive of a lumbar disc herniation. The back may appear scoliotic. Gait often is abnormal.