Physio Health Advice > Cauda Equina Syndrome

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What is it?

Cauda equina syndrome is a rare condition that you may not have heard of, however it can have catastrophic consequences if it is not recognized and treated quickly. This condition occurs in about two percent of cases of herniated lumbar discs, causing loss of lower leg function, incontinence and lower back pain. It is one of the few medical emergencies related to back pain and can be devastating if symptoms persist.

What causes Cauda Equina Syndrome?

At the end of the spinal cord there is an area of spinal nerves arranged together in a bundle that looks a little like a horses tail. (In Latin horses tail is cauda equina). These nerves are encased in the spine at the lumbar region.
If for some reason these nerves are compressed, nerve signals to the bowel, bladder and lower extremities can become disrupted. Left untreated, this compression can cause permanent paraplegia and incontinence.
Common causes of compression are disc herniation associated with disc degeneration, tumours, inflammatory disorders, spinal stenosis or complications from surgery. Trauma-related cauda equina syndrome from knife wounds or motor vehicle accidents can affect people of all ages.

Signs and Symptoms

This disease is difficult to diagnose because its symptoms mimic many other conditions. However, there are a few symptoms that health professionals know to take very seriously.

These include:
• Sudden loss of reflexes in the legs
• Unusual and rapid onset of Bladder/bowel incontinence or sexual dysfunction
• Pain in one or both legs
• Motor and sensory loss
• Tingling or numbness in the saddle region (Groin and inner thighs)
• Bilateral sciatica

These symptoms may be associated with severe low back pain and if you suddenly experience more than one, particularly incontinence, contact a health professional immediately.

Treatment Options

Treatment will depend on the severity and cause of the syndrome. However, most of the time cauda equina syndrome requires decompression surgery as soon as possible to relieve pressure on the nerves. The longer the period between symptom onset and surgery, the less likely it is for a full recovery. Most patients will need physiotherapy, pain management and counseling even if their condition is treated quickly. Recovery time is based on the amount of damage to the nerves.
While this a very rare condition, public education is important, as rapid treatment is vital to prevent permanent damage.

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