As trained, healthcare professionals, an absolutely crucial part of the role we play in assessing and treating people who come to see us, is identifying when people need to be referred on for additional tests and care.

If we’re not happy with something you’re presenting with or want a second opinion, we make sure we point you in the right direction, armed with information to help you in the best possible way.

Thankfully, serious conditions are very rarely seen in the clinic, although they do sometimes occur. Our team are highly trained to spot any worrying signs or symptoms. One such condition, that we may pick up on when people come to us with back pain, is Cauda Equina Syndrome.

What is Cauda Equina Syndrome?

The spinal cord extends from the brain down through a canal inside the vertebral column. At each level of the spine nerves branch off from your spinal cord (nerve roots) and are responsible for sending signals to and from the muscles and other structures throughout your body. The spinal cord finishes just above your waist, below this is the group of nerves called the Cauda Equina. The nerves of the Cauda Equina supply the muscles that control the bladder, bowel and the legs. Cauda Equina Syndrome is the symptoms which occur when the nerves of the Cauda Equina are compressed.

What causes Cauda Equina Syndrome?

Numerous causes of Cauda Equina syndrome have been reported, the most common being, very large disc prolapse or spinal stenosis (a narrow spinal canal). Less common causes include tumour, infection, or trauma. Cauda Equina syndrome is rare but when it does occur it tends to be in adults of any age.

How is it diagnosed?

Initially the diagnosis of Cauda Equina Syndrome is made from the information that you tell the clinician who assesses you. The examination findings are useful in that they give an indication of how urgently the problem needs treatment.

Treatment

If Cauda Equina Syndrome is confirmed on the scan, urgent spinal surgery is indicated, to prevent permanent damage to the nerves which supply the bladder and bowel.

Symptoms

Cauda Equina Syndrome presents as one or a combination of the following symptoms. Most commonly these symptoms develop suddenly and may worsen rapidly, within hours or days. However, some people develop symptoms gradually.

• Saddle Anaesthesia
• Loss of feeling between the legs
• Numbness in or around the back passage and/or genitals
• Inability to feel the toilet paper when wiping
• Bladder disturbance
• Inability to urinate (pass water)
• Difficulty initiating urination (urinary hesitancy)
• Loss of sensation when you pass urine
• Inability to stop or control urination (incontinence)
• Loss of the full bladder sensation
• Bowel disturbance
• Inability to stop a bowel movement (incontinence)
• Constipation
• Loss of sensation when passing a bowel motion.
• Sexual problems
• Inability to achieve an erection or ejaculate (Males)
• Loss of sensation during intercourse

If you suddenly develop any of the above symptoms then it is strongly recommended that you contact your GP as an emergency or an accident and emergency department.