Table of ContentsView AllTable of ContentsAnatomyFunctionAssociated ConditionsRehabilitationFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Anatomy
Function
Associated Conditions
Rehabilitation
Frequently Asked Questions
The sacral plexus is a network of nerves emerging from the lower part of the spine. These nerves provide motor control to and receive sensory information from most of the pelvis and leg.
A plexus is a web of nerves that share roots, branches, and functions. There are several plexi (plural of plexus) throughout the body, and the sacral plexus covers a large area of the body in terms of its motor and sensory nerve function. Often described as part of the lumbosacral plexus, the sacral plexus is located lower in the body than any of the other nerve plexi.
Every person has two sacral plexi, one on the right side and one on the left side; the two sides are symmetrical in structure and function.
Gilaxia / Getty Images
Structure
Spinal nerves L4 and L5 make up the lumbosacral trunk, and the anterior rami of sacral spinal nerves S1, S2, S3 and S4 join the lumbosacral trunk to form the sacral plexus. “Anterior rami” means the branches of the nerve that are towards the front of the spinal cord (i.e., front of the body); rami is plural for ramus.
At each level of the spine, an anterior motor root and a posterior sensory root join to form aspinal nerve. Each spinal nerve then divides into an anterior (ventral) and a posterior (dorsal) rami (portion), each of which can have motor and/or sensory functions.
The sacral plexus divides into several nerve branches, which include:
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Location
The spinal nerves that comprise the sacral plexus emerge from the lateral (side) regions of the spinal cord. Each of these nerves travels through its corresponding spinal foramen (opening) before they join in their various combinations to form the sacral plexus in the back of the pelvis.
The sacral plexus branches into smaller nerves within the pelvis. Some of the nerves remain the pelvis and some extend down the leg. Some nerves of the sacral plexus exit the pelvis through the greater sciatic foramen—a large opening comprised of pelvic bones that contains muscles, nerves, and blood vessels—and then travel down the leg.
The Lumbar Spine
Anatomical Variations
There are a number of natural variations in the structure of the sacral plexus. These variations typically do not cause any clinical problems, but they may be detected on an imaging study, or they can be observed during a surgical procedure.
Sometimes, nerves of the sacral plexus may be larger or smaller than average, or a spinal nerve that typically contributes nerve fibers to a nerve of the sacral plexus might not do so. The plexus may form or divide at a higher or lower region in the pelvis than expected.
The sacral plexus has extensive functions throughout the pelvis and legs. Its branches provide nerve stimulation to a number of muscles. The nerve branches of the sacral plexus also receive sensory messages from the skin, joints, and structures throughout the pelvis and legs.
Motor
Motor nerves of the sacral plexus receive their messages from the motor area of the brain, which sends the messages down the ventral (front) column of the spine, out to the sacral plexus, and eventually to the motor nerve branches of the sacral plexus to stimulate muscle contraction (movement).
Motor nerves of the sacral plexus include:
Superior gluteal nerve: This nerve provides stimulation to the gluteus minimus, gluteus medius, and tensor fascia lata, which are muscles that help move the hip laterally (away from the center of the body).
Inferior gluteal nerve: This nerve provides stimulation to the gluteus maximus, a large muscle that moves the hip laterally.
Sciatic nerve: The sciatic nerve has a tibial portion and a common fibular portion, which have motor and sensory functions.
Pudendal nerve: The pudendal nerve (which also has sensory functions) stimulates the muscles of the urethral sphincter to control urination and muscles of the anal sphincter to control defecation (pooping).
The nerve to thequadratus femorisstimulates the muscle to move your thigh.
The nerve to theobturator internusmuscle stimulates the muscle to rotate the hip and stabilize your body when you walk.
The nerve to thepiriformis musclestimulates the muscle to move your thigh away from your body.
Sensory
The sensory fibers of the sacral plexus receive nerve messages from the skin, joints, and muscles. These messages are sent up through the nerves of the sacral plexus and to the spine, where they travel in the dorsal (back) column of the spine and up to the sensory regions of your brain to make you aware of your sensations.
Sensory nerves of the sacral plexus include:
Posterior femoral cutaneous nerve: This nerve receives sensory messages from the skin on the back of the thigh and leg, as well as the pelvis.
Sciatic nerve: The tibial and common fibular portions of the sciatic nerve both receive sensory information from the leg. The tibial portion receives sensory information from most of the foot. The common fibular portion receives sensory messages from the front and sides of the leg and from the back of the foot.
Pudendal nerve: This nerve receives sensory information from the skin of the genital areas.
Because this network of nerves has many branches and portions, the symptoms can be confusing. You may experience sensory loss or pain of regions in your pelvis and leg, with or without muscle weakness.
The pattern might not necessarily correspond to a single nerve, making it difficult to identify which parts of the sacral plexus are affected.
Conditions that affect the sacral plexus include:
Recovery and rehabilitation of a disease or injury of the sacral plexus is possible. In general, recovery is better when the symptoms are detected early and the illness is diagnosed before serious nerve damage has occurred. Less extensive damage and involvement of fewer nerve branches are also associated with better recovery.
Treatment of the Underlying Medical Problem
Rehabilitation begins with treatment of the cause of the problem—such as treatment for cancer (surgery, chemotherapy and/or radiation) or antibiotic treatment for an infection. Treatment of neuropathy is often complicated because the cause may be unclear, and a person can experience several causes of neuropathy at the same time. Healing after a major pelvic trauma (such as from a car accident) can take months, especially if you have had multiple bone fractures.
Motor and Sensory Recovery
Physical therapyandoccupational therapycan help you regain your strength and motor control as you are healing from a sacral plexus disease or injury.
Adapting to sensory deficits is an important part of rehabilitation and recovery from a sacral plexus problem. Sensory problems can interfere with your ability to walk, as you might not be able to properly feel your own position as you are moving.
Sensory deficits may make you less sensitive to pain, which can worsen the effects of injuries (when you don’t take care of them or avoid further trauma).
And sometimes, rehabilitation for bowel and bladder function may require exercises, as well as medication that can help control these functions.
Learn MoreThe Anatomy of the Sacral Vertebrae
Dorsal ramirefer to the nerves located on the back side of the spinal cord.Ventral rami, or anterior rami, are the nerves located on the front side.
10 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Matejcík V.Anatomical variations of lumbosacral plexus.Surg Radiol Anat. 2010;32(4):409-14. doi:10.1007/s00276-009-0546-3Muniz neto FJ, Kihara filho EN, Miranda FC, Rosemberg LA, Santos DCB, Taneja AK.Demystifying MR neurography of the lumbosacral plexus: from protocols to pathologies.Biomed Res Int. 2018;2018:9608947. doi:10.1155/2018/9608947Neufeld EA, Shen PY, Nidecker AE, et al.MR imaging of the lumbosacral plexus: a review of techniques and pathologies.J Neuroimaging. 2015;25(5):691-703. doi:10.1111/jon.12253Ng PS, Dyck PJ, Laughlin RS, Thapa P, Pinto MV, Dyck PJB.Lumbosacral radiculoplexus neuropathy: incidence and the association with diabetes mellitus.Neurology. 2019;92(11):e1188-e1194. doi:10.1212/WNL.0000000000007020Staff NP, Windebank AJ.Peripheral neuropathy due to vitamin deficiency, toxins, and medications.Continuum (Minneap Minn). 2014;20:1293-306. doi:10.1212/01.CON.0000455880.06675.5aBrejt N, Berry J, Nisbet A, Bloomfield D, Burkill G.Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge.Cancer Imaging. 2013;13(4):591-601. doi:10.1102/1470-7330.2013.0052Rubin M.Plexus disorders. Merck Manual.Garozzo D, Zollino G, Ferraresi S.In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.J Brachial Plex Peripher Nerve Inj. 2014;9(1):1. doi:10.1186/1749-7221-9-1Custodio C, Douglas W, Von Rickenbach K.Lumbosacral plexopathy and sciatic neuropathy: differential diagnosis and treatment. American Academy of Physical Medicine and Rehabilitation.Scott KM.Pelvic floor rehabilitation in the treatment of fecal incontinence.Clin Colon Rectal Surg. 2014;27(3):99-105. doi:10.1055/s-0034-1384662Additional ReadingSollmann N, Weidlich D, Cervantes B, Klupp E, Ganter C, Kooijman H, et al.T2 mapping of lumbosacral nerves in patients suffering from unilateral radicular pain due to degenerative disc disease. J Neurosurg Spine. 2019 Feb 22:1-9. doi:10.3171/2018.10.SPINE181172.
10 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Matejcík V.Anatomical variations of lumbosacral plexus.Surg Radiol Anat. 2010;32(4):409-14. doi:10.1007/s00276-009-0546-3Muniz neto FJ, Kihara filho EN, Miranda FC, Rosemberg LA, Santos DCB, Taneja AK.Demystifying MR neurography of the lumbosacral plexus: from protocols to pathologies.Biomed Res Int. 2018;2018:9608947. doi:10.1155/2018/9608947Neufeld EA, Shen PY, Nidecker AE, et al.MR imaging of the lumbosacral plexus: a review of techniques and pathologies.J Neuroimaging. 2015;25(5):691-703. doi:10.1111/jon.12253Ng PS, Dyck PJ, Laughlin RS, Thapa P, Pinto MV, Dyck PJB.Lumbosacral radiculoplexus neuropathy: incidence and the association with diabetes mellitus.Neurology. 2019;92(11):e1188-e1194. doi:10.1212/WNL.0000000000007020Staff NP, Windebank AJ.Peripheral neuropathy due to vitamin deficiency, toxins, and medications.Continuum (Minneap Minn). 2014;20:1293-306. doi:10.1212/01.CON.0000455880.06675.5aBrejt N, Berry J, Nisbet A, Bloomfield D, Burkill G.Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge.Cancer Imaging. 2013;13(4):591-601. doi:10.1102/1470-7330.2013.0052Rubin M.Plexus disorders. Merck Manual.Garozzo D, Zollino G, Ferraresi S.In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.J Brachial Plex Peripher Nerve Inj. 2014;9(1):1. doi:10.1186/1749-7221-9-1Custodio C, Douglas W, Von Rickenbach K.Lumbosacral plexopathy and sciatic neuropathy: differential diagnosis and treatment. American Academy of Physical Medicine and Rehabilitation.Scott KM.Pelvic floor rehabilitation in the treatment of fecal incontinence.Clin Colon Rectal Surg. 2014;27(3):99-105. doi:10.1055/s-0034-1384662Additional ReadingSollmann N, Weidlich D, Cervantes B, Klupp E, Ganter C, Kooijman H, et al.T2 mapping of lumbosacral nerves in patients suffering from unilateral radicular pain due to degenerative disc disease. J Neurosurg Spine. 2019 Feb 22:1-9. doi:10.3171/2018.10.SPINE181172.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Matejcík V.Anatomical variations of lumbosacral plexus.Surg Radiol Anat. 2010;32(4):409-14. doi:10.1007/s00276-009-0546-3Muniz neto FJ, Kihara filho EN, Miranda FC, Rosemberg LA, Santos DCB, Taneja AK.Demystifying MR neurography of the lumbosacral plexus: from protocols to pathologies.Biomed Res Int. 2018;2018:9608947. doi:10.1155/2018/9608947Neufeld EA, Shen PY, Nidecker AE, et al.MR imaging of the lumbosacral plexus: a review of techniques and pathologies.J Neuroimaging. 2015;25(5):691-703. doi:10.1111/jon.12253Ng PS, Dyck PJ, Laughlin RS, Thapa P, Pinto MV, Dyck PJB.Lumbosacral radiculoplexus neuropathy: incidence and the association with diabetes mellitus.Neurology. 2019;92(11):e1188-e1194. doi:10.1212/WNL.0000000000007020Staff NP, Windebank AJ.Peripheral neuropathy due to vitamin deficiency, toxins, and medications.Continuum (Minneap Minn). 2014;20:1293-306. doi:10.1212/01.CON.0000455880.06675.5aBrejt N, Berry J, Nisbet A, Bloomfield D, Burkill G.Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge.Cancer Imaging. 2013;13(4):591-601. doi:10.1102/1470-7330.2013.0052Rubin M.Plexus disorders. Merck Manual.Garozzo D, Zollino G, Ferraresi S.In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.J Brachial Plex Peripher Nerve Inj. 2014;9(1):1. doi:10.1186/1749-7221-9-1Custodio C, Douglas W, Von Rickenbach K.Lumbosacral plexopathy and sciatic neuropathy: differential diagnosis and treatment. American Academy of Physical Medicine and Rehabilitation.Scott KM.Pelvic floor rehabilitation in the treatment of fecal incontinence.Clin Colon Rectal Surg. 2014;27(3):99-105. doi:10.1055/s-0034-1384662
Matejcík V.Anatomical variations of lumbosacral plexus.Surg Radiol Anat. 2010;32(4):409-14. doi:10.1007/s00276-009-0546-3
Muniz neto FJ, Kihara filho EN, Miranda FC, Rosemberg LA, Santos DCB, Taneja AK.Demystifying MR neurography of the lumbosacral plexus: from protocols to pathologies.Biomed Res Int. 2018;2018:9608947. doi:10.1155/2018/9608947
Neufeld EA, Shen PY, Nidecker AE, et al.MR imaging of the lumbosacral plexus: a review of techniques and pathologies.J Neuroimaging. 2015;25(5):691-703. doi:10.1111/jon.12253
Ng PS, Dyck PJ, Laughlin RS, Thapa P, Pinto MV, Dyck PJB.Lumbosacral radiculoplexus neuropathy: incidence and the association with diabetes mellitus.Neurology. 2019;92(11):e1188-e1194. doi:10.1212/WNL.0000000000007020
Staff NP, Windebank AJ.Peripheral neuropathy due to vitamin deficiency, toxins, and medications.Continuum (Minneap Minn). 2014;20:1293-306. doi:10.1212/01.CON.0000455880.06675.5a
Brejt N, Berry J, Nisbet A, Bloomfield D, Burkill G.Pelvic radiculopathies, lumbosacral plexopathies, and neuropathies in oncologic disease: a multidisciplinary approach to a diagnostic challenge.Cancer Imaging. 2013;13(4):591-601. doi:10.1102/1470-7330.2013.0052
Rubin M.Plexus disorders. Merck Manual.
Garozzo D, Zollino G, Ferraresi S.In lumbosacral plexus injuries can we identify indicators that predict spontaneous recovery or the need for surgical treatment? Results from a clinical study on 72 patients.J Brachial Plex Peripher Nerve Inj. 2014;9(1):1. doi:10.1186/1749-7221-9-1
Custodio C, Douglas W, Von Rickenbach K.Lumbosacral plexopathy and sciatic neuropathy: differential diagnosis and treatment. American Academy of Physical Medicine and Rehabilitation.
Scott KM.Pelvic floor rehabilitation in the treatment of fecal incontinence.Clin Colon Rectal Surg. 2014;27(3):99-105. doi:10.1055/s-0034-1384662
Sollmann N, Weidlich D, Cervantes B, Klupp E, Ganter C, Kooijman H, et al.T2 mapping of lumbosacral nerves in patients suffering from unilateral radicular pain due to degenerative disc disease. J Neurosurg Spine. 2019 Feb 22:1-9. doi:10.3171/2018.10.SPINE181172.
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