As we know, within your spine, there is
a spinal cord which extends from the
brain down through a canal inside the
At each level of the spine, there are nerves
branching off from your spinal cord.
These are called nerve roots. They are
responsible for sending signals to and
from the muscles and other structures
throughout the body.
The area which we need to concentrate
on is the area of the spine which is
approximately just above the waist.
This area of the spine is where the spinal
cord finishes. Below this is the group of
nerves which are called the Cauda Equina.
The nerves of the
Cauda Equina are
responsible for the
supply of nerves
to the bladder,
bowels, lower limbs
and also supply
sensation to the skin
around the bottom
and back passage.
Cauda Equina Syndrome is the signs and symptoms when the nerves of the Cauda Equina are compressed.
This syndrome has a complex spectrum of signs and symptoms. If your doctor has suspicions of CES, then in some causes it can be confirmed with a MRI scan.
What are the causes of CES?
Whilst the Cauda Equina are protected by
the vertebrae (the back bone). It is still
vulnerable to damage.
Tumours of the Cauda Equina
Spinal Injury Fracture / trauma
Secondary to Medical Procedure
Intra-vertebral Disc Herniated
(Slipped or Prolapsed Disc)
Vascular Problems of Cauda Equina
Infections of the Cauda Equina
Red Flag Signs & Symptoms
Loss of feeling between the legs
Numbness in or around the back passage and / or genitals
Inability to feel the toilet paper when wiping
Inability to urinate
Difficulty initiating urination
Loss of sensation when you pass urine
Inability to stop or control urination
Loss of the full bladder sensation
Inability to stop a bowel movement
Loss of sensation when passing a bowel motion
Inability to achieve an erection or ejaculate
Loss of sensation during intercourse
Nerve Root Pain
It is quite common to have a
combination of back pain, leg pain,
leg numbness or weakness. These
symptoms however are common
in people who have a history of back
problems but do not have Cauda
In the past, many patients have delayed presenting themselves to a healthcare professional, as they have not recognised the significance of their symptoms.
By delaying obtaining specialist spinal care, it can result in devastating disability. By receiving thorough assessments and timely referrals to spinal specialists this will increase better outcomes for
Recent literature currently suggests that the outcome of surgical decompression is better if decompression is carried
out within 48 hours of the onset of red flag symptoms.
This condition requires emergency referral to a specialist spinal team, as they would be able to confirm the
diagnosis and treat the condition accordingly.