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The Los Angeles Lakers will open the NBA season Tuesday night against the Golden State Warriors without their most revered star. The team announced on Oct. 9 that LeBron James will miss the start of his 23rd campaign because of sciatica.
What had previously been described as “nerve irritation in the glute” during training camp and the preseason has now been diagnosed as full-blown sciatica, sidelining the future Hall of Famer. ESPN’s Shams Charania reported James is targeting a mid-November return.
Lakers head coach JJ Redick left the return date open-ended, saying, “He has his own timeline.”
Here’s what sciatica is and how it could affect James:
Sciatica occurs “when irritation, inflammation, pinching, or compression affect one or more nerves that run down the lower back and into the legs,” according to the Cleveland Clinic. The condition is typically not considered serious and often improves with rest and self-care. A herniated disc is the most common cause.
“Disc herniation tends to be self-limiting,” said Dr. Santhosh Thomas, an expert in Interventional Spine and Musculoskeletal Medicine at the Cleveland Clinic. “Most people get better within a few weeks, maybe a few months, but you can speed it up by having spinal injections.
“Or if you have profound weakness, you may want to consider surgical options. But most people do not need to go through the surgical route. Medication, rehab medication, either by mouth or spinal injections, can be very good alternatives to surgical options in these patients.”
The sciatic nerve — the largest in the human body — runs from the lower back down the back of the thigh before splitting below the knee. It is not one nerve but a collection of five different ones. The L4, L5, S1, S2 and S3 nerves make up the entire system.
“Irritation of any of these nerves will present with symptoms, and they could be in different parts of the legs,” Dr. Thomas said. “It could be a lot of areas to figure out which nerve and what part of the nerve fibers are getting pinched.”
The L4, L5 and S1 nerves make up the nervous system in the glute, where James’ discomfort was initially reported to be. While a herniated disc is the most common cause, spinal stenosis — a condition that refers to the narrowing of a passageway or channel in the body — is also found to be a cause. If spinal stenosis is present, then the recovery would take longer.
The symptoms of sciatica are often described as burning or an electric shock, radiating down the leg and triggered by movements such as coughing, sneezing or bending.
Roughly 40 percent of people experience some form of sciatica in their lifetime, though it’s rare in those under 20 unless injury-related. James, 40, reportedly suffered the injury during an on-court workout in late July or early August, according to Charania.
Treatment typically involves reducing physical activity and gradually reintroducing movement with stretching and mobility work. More advanced care can include prescription medication, massage therapy and physical therapy.
The Cleveland Clinic explains that many cases go away within four to six weeks without needing professional treatment. Theoretically, under this timeline — with James receiving top-of-the-line care — it would align with the targeted mid-November return date. More severe cases can potentially take weeks or months to get better. It’s unclear the severity of James’ sciatica.
While he is already more susceptible to potential reaggravation, were he to rush back without a full recovery, James could also find himself adjusting his play style. Whether consciously or subconsciously, minor adjustments could potentially cause more injuries, according to Thomas.
“If you’re alternating your gait or running pattern or twisting pattern just to protect yourself, you may use accessory muscles that normally are not used for that particular activity,” Thomas said. “Say you’re jumping and you’re afraid that this particular landing is going to affect you. You may change your stance, which may make new structures get involved. That can lead to new pain, new spasms in the back, which could be oftentimes muscles.”
The four-time league MVP is averaging 27.0 points, 7.5 rebounds, 7.4 assists in 1,562 regular-season games. His 22 NBA seasons played are tied with Vince Carter for the most in league history.
The Lakers are 248-177 with James on the court since he joined the team in 2018-19. Without him, Los Angeles is 56-78 (.418). This season will be James’ eighth with the Lakers, making it his longest uninterrupted stint with a team in his career.
