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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.

Treatments

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The London Independent Hospital
1 Beaumont Square, London E1 4NL

0808 101 0337

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The London Independent Hospital
1 Beaumont Square, London E1 4NL

0808 101 0337

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London Clinic
20 Devonshire Pl, Marylebone, London W1G 6BW

02079354444

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Lycahealth Canary Wharf
1 Westferry Circus, Canary Wharf, London E14 4HD

020 7132 1440

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Hospital of St John and St Elizabeth
60 Grove End Rd, London NW8 9NH

020 7806 4000

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Blackheath Hospital
40-42 Lee Terrace, Blackheath, London SE3 9UD

020 8318 7722

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London Bridge Hospital
27 Tooley St, London SE1 2PR

020 7407 3100

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Bupa Cromwell Hospital
164-178 Cromwell Rd, Kensington, London SW5 0TU

020 7460 2000

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The Wellington Hospital
Wellington Pl, London NW8 9LE

020 3733 5344

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Highgate Hospital
17-19 View Rd, Highgate, London N6 4DJ

020 8341 4182

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Otima health
19 Harley St, Marylebone, London W1G 9QJ

020 7036 8800

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Harris Private and International Patient Unit, Great Ormond Street Hospital
Great Ormond St, London WC1N 3JH

020 7405 9200

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The Portland Hospital
205-209 Great Portland St, London W1W 5AH

020 3627 1534

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