The typical history is that the patient often complains of episodes of back and leg pain related to a particular trauma. However, patients often complain of intermittent episodes of back and leg pain over a period of months or even years. Symptoms may be exacerbated by factors such as excessive physical activity, repeated bending and twisting, and lifting heavy objects. Typically, the pain starts in the low back and radiates to the sacroiliac joints and buttocks. The typical radiating pain spreads below the knee, corresponding to the distribution of the affected nerve roots. The radiating pain is often accompanied by abnormal sensation and weakness in the area innervated by the affected nerve roots. Patients often have more intense pain in the legs than in the lower back. Sitting, exertion, sneezing and coughing may aggravate the pain, while standing and bed rest may reduce it.