CAUDA EQUINA SYNDROME
THE FIRST THING EVERYBODY NEEDS TO BE AWARE OF WITH A NEW EPISODE OF LOW BACK PAIN
WHAT IS IT?
Cauda equina syndrome is an exceptionally rare, but potentially life changing condition. It will one of the first things that a healthcare professional screens you for if you have a new episode of low back pain.
It refers to an area of nerve roots at the lower end of the spinal cord, that in rare instances, can become compressed. These nerves are responsible for your bladder and bowel function, your sexual function and the power and sensation in your legs. The longer these nerves are compressed for the higher the chance of having long term problems with all of the aforementioned faculties.
SIGNS & SYMPTOMS
Bladder Dysfunction
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An acute increase in bladder frequency.
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Bladder incontinence - lack of bladder control, inability to stop flow, lack of awareness that you are passing urine, lack of having the urge to pass urine.
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Bladder retention - difficulty initiating flow, inability to initiate flow, decreased flow power, not feeling like you have fully emptied your bladder when you have been.
Bowel Dysfunction
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Lack of control, inability to delay a bowel movement.
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Lack of awareness of when you have stopped.
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Reduced/lack of sensation when passing a stool
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Constipation is not a concern.
Saddle Anaesthesia
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Numbness or decreased sensation around your genitals, anus or perineum. Any area of skin that would be in contact with the saddle on a bike.
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More subtly we might ask questions like: do you have sensation when wiping yourself? If you were to sit on a bike can you feel the area of skin that is contact with the saddle?
Sexual Dysfunction
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Males - any difficulties achieving or maintaining an erection or any difficulties ejaculating
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Females - applies to lack of sensation during intercourse.
Bilateral Sciatica
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This normally presents as neuropathic/nerve pain and/or parasthesia (pins and needles or numbness) travelling down both legs.
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Normally describe sharp, shooting, electric, lancinating type pain.
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Numbness or decreased sensation around your genitals, anus or perineum. Any area of skin that would be in contact with the saddle on a bike.
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More subtly we might ask question like: can you feel when you’re going to the toilet and wiping yourself? If you were to sit on a bike would you have sensation in that area?
Gait Disturbances
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Sudden loss of power or control of your legs
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Foot drop (inability to flex foot upwards)