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The cauda equina is a bundle of nerve roots at the lower base of the spine. It is responsible for sending nerve signals back and forth between your brain and your lower limbs and pelvic organs. Cauda equina syndrome (CES) is a rare condition where the cauda equina becomes compressed or severely squeezed. Herniated discs placing pressure on the cauda equina is the most common cause of CES.


CES symptoms may develop slowly and worsen over time as the cauda equina becomes more and more compressed. Sometimes the slow progression of CES can make it difficult to diagnose, and it may be misdiagnosed during its early stages. Typically, the bladder and legs are among the first areas affected by CES. Symptoms of CES include:

  • Severe lower back pain
  • Weakness in one or both legs
  • Pain in one or both legs
  • Bowel or urinary incontinence
  • Loss of reflexes in lower limbs
  • Sexual dysfunction
  • Numbness or tingling in buttocks


CES is usually the result of a herniated disc placing excessive pressure on the cauda equina. Herniated discs are likely to occur in athletes, obese individuals, or individuals with jobs that require heavy lifting.  Other possible causes of CES include:

  • Tumors on the lower spine
  • Spinal infection
  • Spinal stenosis
  • Birth defects
  • Complications during spinal surgery


If the CES stems from a herniated disc, then conservative methods may be put in place to help heal that issue without surgery. For severe CES cases, surgery may be required to help relieve pressure on the nerves. If CES went untreated for an extended period of time, it may have affected the patient’s ability to walk. In those cases, physical therapy is recommended to improve leg function and help regain strength.

For a comprehensive evaluation from the experts at Brain2Spine Institute, call 727-828-8400.

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