In plain words
Cauda equina syndrome is a rare but serious pressure on the bundle of nerves at the bottom of the spinal canal. These nerves control the legs, the bladder, and the bowel, and they carry feeling from the groin and inner thighs. Pressure can come from a disc, a bleed, an infection, or a growth. Warning signs include numbness in the groin or inner thighs, weakness in both legs, trouble starting or controlling urine, and loss of bowel control. Back pain that comes with these signs is treated as an emergency. Clinicians act quickly, often with urgent imaging, because delay can lead to lasting loss of function. Most back pain in pregnancy and after birth does not come from this cause.
The deeper version
Cauda equina syndrome is compression of the lumbosacral nerve roots below the conus medullaris, producing some combination of bilateral or asymmetric radicular pain, saddle anesthesia, bladder and bowel dysfunction, and lower-limb weakness. Causes include central disc herniation, hematoma, infection, and tumor. Pregnancy and delivery are rare precipitants, most often through hematoma, infection, or disc herniation. Diagnosis rests on clinical examination and urgent MRI, and decompression is the standard surgical response. Outcomes depend strongly on the time from onset to decompression. The NICE guideline on low back pain and sciatica (2016) sets out the red flags and the emergency pathway. , labor, and belong in the differential when back pain comes with fever, uterine tightening, or bleeding.
Where it comes up
- Back pain and sciaticaPregnancy: Your Body
- Pelvic girdle pain and SPDPregnancy: Your Body
- Back, neck, and shoulder pain from feeding and carryingPostpartum: Your Body
- Postpartum warning signs: the one-page listPostpartum: Your Body
- Peeing after birth and leakingPostpartum: Your Body
What mothers here say about cauda equina syndrome
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Sources
- National Institute for Health and Care Excellence — Low back pain and sciatica in over 16s: assessment and management, NG59, 2016