What is Cauda Equina Syndrome (CES)?
The Chartered Society of Physiotherapists state: Cauda equina syndrome (CES) is a rare condition, occurring in one to three in every 100,000 people. Up to two people in every 100 with herniated lumbar discs may develop the condition.
While cauda equina syndrome is a very rare medical condition, but it is important that prompt and timely action is taken to have an assessment and treatment in an emergency department (A&E). The cauda equina is a part of the spinal cord in your low back and sacral region. The nerves in this area supply and control your bladder, bowel and sexual function. A syndrome is a “group of symptoms which consistently occur together, or a condition characterized by a set of associated symptoms”.
What are the symptoms?
There are a number of causes for some of these symptoms. It is important that if you have back pain and sciatica (particularly in both legs) plus any of the following, you should seek immediate medical review in A&E:
• Loss of feeling or pins and needles between your inner thighs or genitals
• Numbness in and around the back passage or buttocks
• Altered feeling when using toilet paper to wipe yourself
• Increasing difficulty when you are trying to urinate
• Increasing difficulty when you try to stop or control the flow of urine
• Loss of sensation when you pass urine
• Leaking urine or recent need to use pads
• Not knowing when your bladder is either full or empty
• Inability to stop a bowel movement of leaking
• Loss of sensation when you pass a bowel motion
• Change in ability to achieve an erection or ejaculate
• Loss of sensation in genitals during sexual intercourse
• If you are not sure, please contact a doctor for advice including dialling 111.
What should I do if I think I have Cauda Equina Syndrome (CES)?
It is important that you attend accident and emergency (A&E) department without delay.
Please present yourself at A&E and explain your symptoms to the nurses and doctors there.
This will enable the medical team to perform the relevant examination and/or investigations to assess for the cauda equina syndrome. This will involve an essential but intimate examination of how the nerves of the cauda equina and nerves of your legs are working (sensation and strength of the muscles).
If it is determined that you have cauda equina syndrome, the emergency department team will discuss in more detail with you the relevant treatment at that time.
