Doctor Gets Brutally Honest About LeBron James' Sciatica Injury, Lakers Return

The Los Angeles Lakers have a LeBron James problem.

For the first time in his career, the 21-time All-NBA power forward missed his team's season opener last month. James hasn't been available to LA at all for the first four weeks of the 2025-26 regular season. The 6-foot-9 superstar has been struggling with sciatica afflicting his right side since some point in the summer, and had initially been projected to return by now.

In his absence, the Lakers have fared swimmingly, going 8-3 behind the superlative play of five-time All-NBA First Team guard Luka Doncic, the ascendant output of likely first-time All-Star (if he can stay healthy) guard Austin Reaves, and the better-than-expected production of new free agent signings Deandre Ayton, Jake LaRavia, and even Marcus Smart.

With or without the four-time league MVP, Los Angeles appears to be a formidable force in the Western Conference. The 40-year-old James, on an expiring $52.6 million deal, has been the league's oldest active player for three seasons running.

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The rise of Reaves may make James' free agency next summer a bit fraught for the Lakers, who will no doubt seek to retain the 27-year-old shooting guard over an injury-addled old guy angling to play an unprecedented 24th season in 2026-27.

Still, James has recently made some serious inroads towards a comeback.

ESPN's Shams Charania recently revealed that James took part in his first full practice of the year, and his first five-on-five workout. He is putting in reps with LA's G League affiliate in El Segundo, the South Bay Lakers, while the rest of his Los Angeles teammates continue their ongoing road trip.

Details for NBA Today on LeBron James participating in his first full practice and five-on-five session of the Lakers season -- with South Bay in the G League: pic.twitter.com/g4w79jxUaz
— Shams Charania (@ShamsCharania) November 12, 2025

"Sources told me this afternoon that LeBron James looked great, felt great as he went through that practice. He moved well and he didn't show signs of any issues as he worked through this nerve issue on his right side," Charania said. "My understanding right now is that LeBron James is motivated and eager to get back out on the court potentially here, mid-to-late this month."

How worried should fans be about a regression in James' recovery during these next critical weeks? Lakers On SI consulted with Dr. Todd Albert, MD, a spine surgeon at Hospital for Special Surgery in New York with three decades of experience, on what to expect about LeBron James' return.

What Is Sciatica?

What exactly has James been dealing with over these past several months?

"So sciatica is signs and symptoms of irritation of the sciatic nerve. Let's start with what the sciatic nerve is. The sciatic nerve is this big nerve... it's kind of a compilation of three nerves from your spine. So the spinal cord ends right around where your rib cage ends and then there's a bunch of nerves and they have numbers, you've heard of them, L1, L2, L3, L4," Dr. Albert told Lakers On SI.

"It turns into a string of nerves, it looks like a horse's tail. And then each level, one of those nerves goes out — L1, the L1 goes out... And the sciatic nerve is this big nerve that is made up of L4, L5 and S1and comes out through the butt, like the pelvis, the back of the buttocks and the bottom of the pelvis," Dr. Albert said. "And then it turns into nerves that control your thigh muscles, your calf muscles and your foot muscles — L4, L5, and S1. It's those nerves combined together. So what sciatica is, is irritation, generally, of one of those nerves from a herniated disc. People get what's called stenosis, but the most frequent thing is a herniated disc or a bulging disc."

When it comes to James, the sciatica pain resonates down the body, flowing from one of those nerves.

"It presses on them up in the spinal area, but then causes pain that goes down that nerve. What sciatica really means — it's somewhat of a lay term — but what it means is pain that shoots down from the buttocks down to the leg," Dr. Albert said. "It's really, if we're purists about it, it's pain that goes down usually below the knee."

James Finds Himself in An Unfortunate Age Demographic

James' advanced-for-basketball age happens to unfortunately coincide with the moment sciatica issues tend to become more pronounced for people.

"Now, he's superhuman, but if you look at all humans... and you made a chart of age vs frequency of lumbar disc herniation, 40 is the median age for people with herniated discs," Dr. Albert noted. "Now, it's a bell curve, so you see it younger, you see it a lot older, but if you look at most people who have a herniated disc, [the top range is] 35-45."

When it comes to sciatica injuries, it's important to note that they pop up for a large percentage of the population in James' age range. Even ahead of risk factors like smoking, genetics play the biggest role in determining a person's predilection to suffer from sciatica pain.

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"Lots of people have bulging discs... It's a natural [thing]. It's like you say, 'Oh, that 40-year-old, he has a gray hair.' If I went and MRI'd — and it's been done — a thousand people, 40 years old, of their lumbar spine, and they ensured they'd never, ever had pain, literally 33 to 37 percent of them will have bulging discs," Dr. Albert said. "So it's a natural occurrence, but sometimes if it presses on a nerve it can be very painful, or if it herniates."

James and the Lakers' medical personnel will need to communicate about where and if he's feeling pain and loss of strength. There are ways to measure the areas he has lost strength — and how much (if he does have weakness) — relative to where he was pre-injury.

Determining A Recovery Pathway for James

When it comes to James' ramp-up back to on-court play, the Lakers are likely doing things very systematically, and a bit conservatively.

"Look, if he can get to a place where he can jog, do pool work... and not have pain, then introduce the gravity work, then he can start running up and down the court, then he can start getting in positions where he can shoot, do what he has to do," Dr. Albert told Lakers On SI last week, before the announcement of James' return to five-on-five play.

Dr. Albert went on to detail the physical scenarios that could prove most troublesome for the aging superstar.

"If it's a herniated disc, generally bending forward and flexing your body, that gives you more pain. So you have to be careful about what kind of maneuvers do that. In basketball, a lot of it's upright and arching and extension, which often doesn't hurt someone who has a herniated disc unless it is causing severe narrowing of the canal," Dr. Albert noted. "My suspicion is, if he has any weakness, is that what his trainers and therapist would be more worried about is him injuring something else if he can't protect himself. That's what I would be worried about."

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