Minor spinal issues such as lower back pain are fairly typical in the population as a whole and pain in this area is a common reason why many of us will visit the doctor. Due to the sedentary lifestyles that many of us are exposed to these days, issues with back pain are more prevalent than they once were.
More often than not, the underlying cause of lower back pain is not serious and the individual will feel better as time passes. However, pain in this area can be a symptom of something a lot more problematic. One particular condition, for which lower back pain is a primary symptom, is known as cauda equina syndrome (CES).
Here we take a closer look at this condition, what the symptoms are and how it can be treated.
The pain that accompanies cauda equina syndrome can be so severe in many instances that it requires emergency admission to hospital. It’s caused by a compression of the spinal roots in the lower part of the spine.
The cauda equina are a series of nerves located in the lumbosacral area of the spine. They are involved in sending messages to the pelvic organs, including the bladder, as well as the legs, and feet.
Symptoms of cauda equina syndrome can include severe pain, loss of sensation in the lower body as well as bladder and bowel issues. More details about the symptoms of cauda equina syndrome are provided below.
Cauda equina syndrome is a rare condition. In the USA, it affects between 1 in 33,000 and 1 in 100,000 people. It accounts for up to 6% of lumbar disc operations that are carried out yearly.
The most common cause of cauda equina syndrome is a herniated or ruptured disc. In younger patients, this is usually caused by an accident or injury which puts excessive strain on the lumbar region.
In older patients, the degeneration of the spinal area due to age means that the syndrome can be caused by a more minor strain leading to a rupture.
There are other, less common, causes of cauda equina syndrome, including:
Early symptoms of cauda equina syndrome may mimic other spinal conditions, which is why it can be difficult to diagnose in the initial stages. A lot can depend on how the compression of the spinal nerves progresses and the cause of that damage.
If cauda equina syndrome is left untreated it can lead to serious problems, including permanent paralysis. The standard intervention involves surgery to relieve the compression and the quicker this is carried out the better the outlook for the patient.
According to research, treatment within 48 hours of the onset of symptoms provides the best outcome (though a good result can be achieved after this date). This is one reason why it is important that an accurate diagnosis is obtained as soon as possible.
Following a physical examination, the main diagnostic tools used are:
Once surgery has been carried out, the progress made during recovery will vary from person to person. It may take time before motor deficits in the lower limbs are restored and the bladder and bowel begin to function properly once again.
It might take several years to recover from neurogenic bladder or bowel issues. In some cases, full function is not recovered and individuals will need to manage the permanent symptoms of cauda equina syndrome.
If permanent damage has been caused, management will include working with occupational therapists and physiotherapists to improve daily living. There may be emotional challenges that come with chronic cauda equina syndrome, especially in instances where there are persistent bladder or bowel problems and/or the individual continues to experience severe pain.
Cauda equina syndrome is a serious but fairly rare condition that is caused by the compression of nerves in the lumbar region. Fast diagnosis and surgical intervention are vital in ensuring the best outcome, but some affected individuals may have to cope with long-term health issues as a result of their condition.
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