Overview
While back pain is a common problem, it can become a medical emergency when it happens suddenly. This includes sudden numbness and difficulty urinating. Cauda equina syndrome can be caused by a large disc herniation that compresses nerve roots at the ends of the spinal cord. These nerves relay messages to the bladder, bowel, legs, and other parts of the body. It is possible to cause irreversible damage if the nerves are squeezed for too long. It is important to have the pressure relieved immediately in order to prevent irreversible damage.
Herniated Disc Symptoms
A herniated disc can cause pain in the back. It is often felt in the lower part of the spine, also known as the Lumbar spine or Lumbar region. This is what you might feel if your herniated disc is in this area.
- Lower back pain, whether it’s sharp, burning or achy
- Aiming to relieve pain in the lower back, buttocks, or down one leg
- A feeling of weakness, tingling, or numbness on one leg
The cervical spine (or neck) can be affected by a slipped disc.
- Headache, especially at the back of the skull
- Pain in the neck, shoulder and arm that could cause amputations
- Numbness, weakness, tingling or numbness one arm
- Your symptoms may be worsened by sneezing or coughing, as they put pressure on the nerve.
What is Cauda Equina Syndrome?
Cauda Equina syndrome is rare, but can lead to serious complications if it’s not treated immediately. It is caused most commonly by a large disc herniation that compresses nerve roots at the ends of the spinal cord. These nerve roots are bundles and look like a horse’s tail. This is how their names are derived. Cauda equina means “horse’s tail” in Latin.
Cauda equina can be distinguished from other back problems that are chronic or long-lasting. This is because it is an immediate event, similar to a stroke or heart attack. It often occurs quickly and can last from 6 to 10 hours. The classic signs of back pain are accompanied by sudden onsets of numbness and urinary retention. The speedy relief of compression can make a difference in whether the patient lives a normal or paralyzed life.
Cauda Equina can develop gradually in people who have recurrent back problems. There may be a gradual progression of symptoms. Cauda Equina Syndrome is a disorder that affects the bladder nerves. It can have symptoms that are similar to bladder or prostate problems.
What are the symptoms of these conditions?
Cauda equina compress can lead to problems in your bladder, bowel or sexual function. Searing pains in the lower back and buttocks are common. There is also numbness in the “saddle region” (rectal, genital and inner thighs) and tingling. The pain can travel from the back of the thigh down to the knee and up to the foot (sciatica). Paralysis or weakness of the foot or leg may occur, particularly when the person is trying to get out of a chair. Extreme leg weakness, loss of bladder and bowel function, are all signs of an emergency. Get medical help immediately.
What are the causes?
Cauda equina syndrome can result from a ruptured disc. The gel-like core of a spine disc can rupture or bulge through a weak spot in the disc wall, compressing the nerves. Most disc herniations occur at the L4-5 or the L5-S1 discs on the lumbar spine. Sports injury, fall, car accident, or a fall can all cause a fracture to the spine, tear muscle, or damage nerves. A narrowing of your spinal canal (stenosis), an infection, a tumor or a hemorrhage are other causes.
How does a diagnosis get made?
A medical exam will be performed to confirm or disprove a diagnosis of cauda mare. An evaluation includes a complete medical history and a physical examination. A clear sign is an area of loss of sensation. To determine the extent of the compression of the spinal nerves, an MRI scan is performed for patients who complain of severe leg weakness, numbness, loss of bladder, or bowel function. A CT scan and/or a myelogram may be ordered by your doctor.
What treatment options are there?
A patient suffering from acute cauda Equina Syndrome will likely need surgery as an immediate emergency. To relieve pressure on the spine nerves, the goal is to restore sensation to the bladder, bowel, legs and muscles. Depending on the cause of the problem, one of these surgeries may be performed.
A discectomy to treat a herniated disc is the procedure that removes the disc portion that is putting pressure on the nerves. The surgeon will make a small incision at the center of the back. The bony vertebrae are exposed by the surgeon being able to move the spinal muscles aside. The nerve root and disc are exposed by removing a portion of the window made from bone. Carefully removing the disc that had ruptured and compressed the spinal nerves.
Spinal decompression to relieve stenosis involves removing bone spurs, ligaments, and nerves. An incision is made at the back. The surgeon then removes the roof-like bone from the spinal canal. The surgeon then removes soft tissue and bone growths to make room for nerves. Also, tumors and other lesions may be removed.
Clinical trials
Clinical trials involve the testing of new treatments (drugs, procedures and other therapies) in order to establish if they’re safe and effective. Medical care is constantly improving. Research is continuing. The Internet has information on current clinical trials including protocol details, eligibility, and location. You can also sponsor studies through the National Institutes of Health and private industry.
Recovery and prevention
Cauda Equina Syndrome may cause your bladder and bowel functions not to work at all. This can mean you might not know when it is time to urinate, or that you may have difficulty moving your bowels.
Cauda Equina recovery depends on severity and length of nerve compressions before surgery. Urinary retention can make it more difficult to recover fully.
- 90% of patients who experienced tingling and numbness in the genital region (incomplete CESS) have regained normal bladder, stool, and sexual function.
- 20% of patients with complete CES may suffer from bladder retention.
- Recurrent problems following surgery can take up to six months to resolve. Rehabilitation options such as bladder training may be necessary.
Permanent injury victims will need to adjust their lives. Physical therapists can help them learn important self-care skills, including self-catheterization, stress management, and relaxation techniques. For depression, additional assistance may be offered by a psychiatrist, a support group or sex therapist.
Paralysis of the legs might occur in very rare cases.
5 Back Pain Emergencies
Globally, low back pain is the leading cause of disability. A study found that between 75 and 85% of Americans have experienced back pain during their lifetimes. Lower back pain can be caused by problems in the muscles, nerves or spine.
Most back pain is either short-term or acute and can last several days to weeks. Others may develop chronic back problems that last at least three to six months. Back pain emergencies can also occur that require immediate treatment and sometimes even surgery. Here are some signs and symptoms.
Common Symptoms for Back Pain Emergencies
- Severe pain in the back
- Limb weakness
- Manipulation of the bladder or bowel
- Sharp pain in the legs or arms
- Tingling or numbness in various parts of your body
Types of Back Pain Emergencies
You may have back pain if you experience any of these symptoms.
Spinal Fracture
High-energy trauma or accidents can cause spine fractures. The first sign is severe back pain, which can get worse with movement. A fracture of the spinal cord or nerves can cause tingling, weakness, and bladder dysfunction.
Cauda Equina Syndrome (CES)
Cauda Equina, Latin for “horse’s tail”, refers to the bundle of spinal neurons at the end of a spinal cord. CES can be caused by spinal nerve compression. This also causes disturbances in the motor and sensory functions of the bladder, and the lower extremities. CES can cause permanent paralysis at its worst. Symptoms of CES may include severe low back pain and motor weakness, pain in one leg or both legs, sensory loss, inability feel anything in body parts that sit in a saddle, urinary incontinence, sensory abnormalities within the bladder or rectum, loss of reflexes in extremities, and permanent paralysis.
Severe Herniated Disc
Round discs, which act as shock absorbers, cushion the bones in the spine. An injury, sudden strain, or excessive strain can cause the disc’s inner portion to protrude through the outer ring. This is known as a herniated (ruptured) or slipped disc. Because of the severe cases of herniated discs, it is an emergency situation that can cause extreme pain and discomfort. You may feel lower back pain, sharp leg and arm pains, loss of bladder or bowel control, numbness or weakness in your foot or leg, as well as tingling sensations.
Metastatic Spinal Cord Compression, (MSCC).
Metastatic spine cord compression (MSCC), is a form of cancer that can often require emergency treatment. It occurs when the cancer cells press onto the spinal cord and spread to the spine. The most common symptoms are severe back and neck pain. This can be worsened by sneezing, coughing, going to the toilet, or lifting heavy objects. Other symptoms include leg and arm pain, difficulty with bowel control, pain in the abdomen, chest, or stomach, and tingling or numbness in different areas of your body. MSCC can cause paralysis if it is not treated.
Vertebral Osteomyelitis
Vertebral bone marrow inflammation is the most common form of spinal infection. It can be caused by injury to the spinal cord or from a bacterial, fungal, or both. The inflammation may cause the brain, bone marrow, and other anatomical structures to be destroyed. Other than severe back pain, symptoms include fever, weight loss and muscle spasms.
