Identifying Cauda Equina Syndrome and acting early

Cauda Equina Syndrome

At Joy Lane Osteopathic Clinic, Whitstable we always look out for ‘red flag’ indicators that something much more concerning is occurring instead of the typical or expected back pain that we usually witness from back injuries.

Recently a patient sent me their MRI report with a central disc bulge at the base of the spine (L5) pressing on the Cauda Equina (nerves in the base of the back). She was also experiencing difficulty holding her bladder and had numbness around her bottom known as saddle anaesthesia.

This is considered a red flag and a medical emergency. I told her to go straight to A&E where eventually she was blue lighted to King’s Hospital for surgery.

So what is Cauda Equina Syndrome?

Fortunately, it is a rare and a severe type of spinal stenosis (narrowing), where all of the nerves in the lower back suddenly become severely compressed.

Symptoms and Diagnosis

  • Severe low back pain
  • Motor weakness, sensory loss, or pain in one, or more commonly both legs
  • Saddle anaesthesia (unable to feel anything in the body areas that sit on a saddle)
  • Recent onset of bladder dysfunction (such as urinary retention or incontinence)
  • Recent onset of bowel incontinence

If left untreated, Cauda Equina Syndrome can lead to permanent paralysis in the muscle of one or both legs and permanent loss of bladder/bowel control, Loss of sexual sensation.

Thankfully, Cauda Equina Syndrome is a relatively rare condition, comprising around 2–6% of lumbar disc operations [16, 17, 31], with an incidence in the population thought to be between 1 in 33,000 to 1 in 100,000

If you are suffering from any of the above symptoms then please seek urgent medical advice.

Charlie Bannigan – Practice Manager