This picture on the right is a diagrammatic representation of how your spinal cord looks like and where it is situated in your body.
Many people in the world experience lower back pains. In most cases, the pains just disappear after some time even without treatment. In others, the pain might be severe calling for special medical attention. In most cases, severe back pain is a symptom of Cauda Equina. The complication happens any time the Cauda Equina nerve roots are compacted, causing an interruption in the sensory and motor capabilities to the bladder and lower extremities. Patients with this defect are often admitted as an emergency.
Causes of Cauda Equina Syndrome
CES is usually caused by a huge herniated disc located in the lumbar area. An injury or strain can lead to a herniated disc. Nevertheless, disc materials wear out as you grow older, and the ligaments which maintain the bones start to deteriorate. As this takes place, a slight strain or a twisting movement causes the disc to rupture. Other causes of Cauda Equina syndrome include:
- Spinal tumors and lesions
- Spinal inflammation
- Violent injuries against the lower back
- Birth complications
- Lumbar spinal stenosis
- Spinal bleeding
- Spinal anesthesia
- Spine surgery problems
Symptoms of Cauda Equina Syndrome
CES comes with many symptoms depending on the amount of compression at that moment. Other symptoms of the disease include irritation of the nerves, spine compression, conus medullaris syndrome, peripheral nerve disorder, and also a condition called lumbosacral plexopathy.
If you have back pain, you should pay attention to the following:
- Server back pain
- Sensory loss, pain in one leg
- Loss of feeling in areas of your body that sit on a saddle (Saddle anesthesia)
- Unable to manage your urinary flow
- Recent start of bowel incontinence
- Sensory irregularity around the rectum
- Sexual dysfunctions
- Loss of reflexes
When to See a Doctor
It’s advisable that you see a doctor when you have server back pains - you never know what will happen thereafter if you just stick around your house and assume everything is okay. Going to the doctor will help you know your current health status. If you know the reason for the pain, the circumstances will drive you to take the next better option as per the doctor’s instructions.
Your chances of regaining normal function after the doctor's checkup really depend on how long you have stayed with the pain. Most experts agree that patients should undergo surgery to create more space for the nerves in order to have a good chance of complete recovery. This should be done within two days of the onset of the pains.
Treatments for Cauda Equina Syndrome
Treatment for Cauda Equina syndrome is administered depending on the cause of the syndrome:
- Generally, people with the syndrome that is caused by an infection should be treated with the appropriate antibiotic therapy.
- Patients with spinal tumors should be treated with chemotherapy and radiation therapy.
- Patients with groin numbness or loss of bowel control should not wait for more than a day before seeking medical attention. If relief of symptoms is not achieved within that period of time then the patient should undergo surgical decompression to minimize the chances of more injury.
Emergency decompression of the spinal canal is the best treatment for the syndrome. The main aim of this surgical procedure is to relieve pressure on the nerves of the Cauda Equina by eliminating the compressing structures. This helps to increase the space available for the spinal nerves and therefore reduce pain.
For patients with CES caused by herniated disk, it’s advisable that a portion of the bone surrounding the nerves be removed. Undergoing surgery is not a guarantee that you will recover from permanent nerve damage.
2. Other Treatment and Coping Measures
If the nerve damage has occurred due to Cauda Equina Syndrome, then here are some of the ways that you can live and cope well with the situation:
- Other than regular medical attention, seek out other specialists that can help you cope better with your condition. You might want to consult with an occupation therapist, sex therapist, social worker therapist or even a continence advisor. Such sessions will allow you to come to terms with your condition and learn how to take proper care of yourself.
- Engage with your family. This means that you should have a good relationship with your family members. They are the closest people to you and they will help you pay off you hospital bills if need be.
- Take care of yourself daily. Drink plenty of fluids daily so as to clean up your bowel system. Make sure you empty your bowel with a catheter at least 4 times a day. Take responsibility for your personal hygiene. Clean your compound regularly, maintain the cleanliness of your house, and take a shower frequently.
- Monitor the flow of your waste regularly. Use protective gloves and pads to prevent leakage of waste. Dispose of the waste properly.
- Get information from friends or even the internet on how you can manage your condition. If not so, you can join a Cauda Equina support group. While in the group, make sure you become an active participant.
Here is an video in which a patient who has suffered cauda equina syndrome twice shares her experience of dealing with this condition:
Can Cauda Equina Syndrome Be Prevented?
The syndrome cannot be prevented because it is caused by unpredictable factors. There are cases of the cauda equna syndrome that can be prevented especially when it is triggered by IV drug abuse. This can easily be prevented by abstaining from illegal drugs. Drugs like Cannabis and excessive alcohol will destroy your bowel system and this can increase the chances of getting Cauda Equina syndrome.