Cauda Equina syndrome is a spinal condition that its worth being aware about. Its uncommon, thankfully, but life changingly serious hence why I thought I’d write about it. Anyone who walks into the clinic with lower back pain gets this lecture.

When the spinal cord gets to the lumbar spine (L1) it starts to splay out like a horse’s tail, the Latin for which is Cauda Equina.

What is it?

Its compression of the lumbar nerves at the base of the spine which provide sensation to your legs, bladder, bowels and the area of skin around them.  Common causes are disc herniation and slippage of the vertebral body but there are other less common causes.

What are the symptoms?

The symptoms are not clear cut, but they can include lower back or leg pain coupled with;

Pins & needles or numbness in the saddle and seat (genitalia) area.

Bilateral sciatic pain (neural pain in both legs).

Changes in bladder and bowel frequency. If someone goes to the bathroom once or twice a night and that’s normal for them, then fine, but if that suddenly turns into four times a night, or day, then that’s a change for them.

Changes in bladder and bowel sensation. Not being able to feel when you go to the loo or not being able to ‘push’ or initiate a stream of urine. Loss of desire to void your bowels or urinary retention without pain.

Not being aware you need the bathroom until its almost too late or incontinence.

A symptom that’s missed is a complete absence of period pain during menstruation.

For ladies, not being able to feel anything during intercourse, for gentlemen, not being able to achieve erection – loss of sexual function.  

What happens if the symptoms are not addressed?

The damage can be irreversible to the bladder, bowel (incontinence) or sexual function. Complete loss of sensation to the genitalia or lower limbs or loss of function on the lower limbs.

If you have these symptoms, forget the GP, go straight to A&E, have an uncomfortable conversation, it could make all the difference. If it’s a positive case it will be identified usually by MRI and the nerve decompressed.

I’ve sent a few people to A&E and THANKFULLY, most cases have been ruled out so just because you have these symptoms does not mean its cauda equina, but DO have it checked out.