Cauda equina syndrome is a combination of symptoms caused by pressure on the bundle of nerves within the lumbar canal (cauda equina). This bundle also contains the bowel and bladder nerves. Cauda equina syndrome can be the result of a variety of causes and needs immediate medical attention! The most common cause is a large disc protrusion. Other causes include infection (discitis), tumour, trauma or following spinal surgery.
The classical symptoms are bilateral leg pain (sciatica), incontinence of urine and/or faeces and numbness in the area of the anus and genitalia (saddle anaesthesia or perianal numbness). It is possible to have only some and not all of these symptoms. Cauda equina syndrome without any pain, however, is very unusual. Many patients with severe back pain or sciatica find it difficult to pass urine because of the pain rather than pressure on the bowel and bladder nerves but if there is any doubt, patients need to be assessed by a doctor urgently. Patients also may have weakness or numbness of the leg or foot or sexual dysfunction.
If untreated cauda equina syndrome can lead to permanent incontinence of bowel and bladder.