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Cauda equina syndrome: The ‘red flag’ symptoms everybody with back pain needs to know about

Herniated – or ‘slipped’ or ‘bulging’ – discs are actually quite common, and only a small proportion of people with them will go on to develop serious ongoing problems or need surgery. But there are instances when a disc problem can become a medical emergency – a condition known as ‘cauda equina’ syndrome – and urgent decompression surgery might be required. While thankfully very rare, unless treated promptly cauda equina syndrome may result in permanent nerve damage, which can range from sensation loss and difficulty walking to paralysis and impaired bladder and bowel control. Remember, this is a rare and uncommon complication, but it’s useful to be aware of the ‘red flag’ warning signs. And if you’re concerned about back pain and sciatica, book a consultation with one of our experts. Here’s a closer look at what cauda equina syndrome means and the possible warning signs:

What is cauda equina syndrome?

The cauda equina is a group of nerves and nerve roots in the lumbar spine (‘Cauda equina’ is Latin for ‘horse’s tail’ – because the nerves sort of resemble dangling tail hairs!). They play a big part in bladder and bowel control as well as, to some degree, as sensation and movement in the legs and sexual function. Cauda equina syndrome occurs when these nerves become dangerously compressed, or oxygen or blood supply to the nerves is blocked or significantly reduced, and it can come on suddenly (acute) or gradually over a period of time. While, as mentioned above, protruding discs are one of the causes, cauda equina syndrome can also be caused by trauma or infection affecting the area, or a growth such as a tumour.

What are the warning signs?

These symptoms don’t necessarily mean you have cauda equina syndrome, but it’s always best to get them checked out urgently – especially if you have a history of nerve compression, spinal surgery or spinal stenosis – as the condition can progress quickly and prompt treatment is paramount.

Numbness

This especially relates to numbness/loss of sensation in the ‘saddle’ area, around the groin, genitals, perineum and buttocks, but it can sometimes start with numbness in the leg. If in doubt, tell your doctor immediately.

Loss of bladder or bowel control

This might be complete loss or just partial disturbance and might mean incontinence (inability to ‘hold it in’) or retention (inability to ‘go’). This is often one of the more severe symptoms, so don’t delay in getting checked out.

Pain

Of course, pain is a frequent symptom of problematic discs – but if you’re experiencing sudden severe pain, or worsening pain in your back and/or affected leg (sciatica), let a doctor know.

Loss of power and movement

Losing power in your foot/feet or leg/legs (or both) – perhaps you’re struggling to stand or walk, or lift your foot – can also be a red flag symptom of cauda equina syndrome.