Cauda Equina Syndrome (CES) is a rare and life changing condition. It is a surgical emergency, so speed is of the essence.
The cauda equina (Latin for horse’s tail) is a bundle of nerves in the lower back. The name comes from the appearance of the nerves, which look like a horse’s tail, at the lower end of the spinal cord. These nerves send and receive messages from the legs, feet and pelvic organs.
CES occurs when this collection of nerve roots become severely compressed.
The cause is usually impingement of the nerves when a disc causes compression of the nerves or inflammation in the area, or following surgery to repair a herniated disc in the spine.
The condition can also be caused by spinal stenosis (an abnormal narrowing of the spinal canal), cancer and trauma.
If you suspect that you have any of the red flags of CES (as seen on our ‘red flags’ page), you need URGENT medical help.
Speed is of the essence and acting quickly may prevent potentially serious permanent damage. It is important to note that once nerves are damaged, they usually do not recover.
The onset of symptoms can be sudden in some cases and gradual in others.
Back pain could be a sign of CES:
DIFFERENT TYPES OF BACK PAIN
Mechanical back pain:
Pain that is felt in the back and is exacerbated by “using” the back for activities such as bending, lifting, standing or sitting exacerbate pain. Typically this pain is relieved by rest. Mechanical back pain can be referred, into the buttock, groin and/or thigh, as far as, but not below the knee. Referred pain can be unilateral (one sided) or bilateral (on both sides).
(Mr N V Todd MB BS PgDL MD FRCPE FRCS)
Radicular (Nerve Root) Pain:
Pain that radiates down the leg into the calf, ankle or foot. Pain may be associated with symptoms or signs of nerve root compression including dermatomal sensory disturbance, myotomal weakness and/or change in a reflex. The commonest causes of nerve root compression are a lateral disc prolapse or stenosis (narrowing) of the nerve root canal.
(Mr N V Todd MB BS PgDL MD FRCPE FRCS)