Cauda Equina Syndrome: Symptoms, Causes & Treatment

Latin for "horse's tail," the cauda equina is the bundle of nerve roots that continues from the end of the spinal cord and supplies sensory and motor function to the legs, bladder and bowel. Cauda equina syndrome is a rare and serious disorder that occurs when these nerve roots become compressed and injured by a herniated disk, disease or trauma. Symptoms may appear rapidly, or come on gradually over weeks or months, according to the New York-Presyterian hospital website.

Pain

• Low-back pain is a primary sign of cauda equina syndrome, and often the main reason a person with this syndrome decides to see a doctor. Depending on the cause of the syndrome, the pain may be severe with a rapid onset, or be aggravating and chronic. It might radiate to one or both legs.

Loss of Sensation

• Cauda equina syndrome can cause a progressive loss of sensation or numbness in the thighs and buttocks, particularly in the area that would sit on top of a saddle. This altered sensation might spread down the back of the legs to the heels and feet. Loss of sensation in this area also can lead to sexual dysfunction.

Weakness

• An individual with cauda equina syndrome can also develop weakness in her legs, resulting in difficulty when getting up from a sitting position. She might have some trouble walking, with the weakness causing her to stumble.

Bladder and Bowel Dysfunction

• Another symptom of cauda equina syndrome involves problems with bladder or bowel function. The person may have difficulty relieving himself, particularly when first trying to start a urine stream. In contrast, he may become incontinent. Due to loss of sensation in the nerves, the individual may not know when he needs to urinate or have a bowel movement.

Physical Examination Features

• Physicians suspecting cauda equina syndrome look for diminished reflexes in the legs as well as sensory abnormalities, and gauge whether the patient is unable to feel light pressure in the saddle area. They also check for weakness in the legs, and signs of muscle wasting, which may occur in chronic cases of cauda equina syndrome.