What is Cauda Equina Syndrome? Brighton Chiropractor Explains.

Disc bulges, also called disc prolapse, disc herniation or slipped disc are common in the spine but most don’t cause any symptoms. When they do cause symptoms you can get back pain and sciatica. With the right chiropractic care most get better in a few weeks. Sometimes, however, the disc bulge is so big it compresses not just the sciatic nerve but the spinal cord itself. This is called Cauda Equina Syndrome (CES) and is a serious and sometimes hard to detect condition that, when suspected, needs immediate attention. Read on to find out the symptoms and potential causes of CES. 

What is Cauda Equina Syndrome? 

Cauda Equina refers to the collection of nerves at the bottom of your spine, named after its resemblance to a horse’s tail. They provide muscle and sensory function to the bladder and legs. CES is a combination of symptoms caused by the compression of these nerves. It is a form of spinal stenosis, which occurs when the space around the spinal cord becomes narrow, restricting the surrounding nerve tissue.

What Causes Cauda Equina?

Causes of CES are still little understood, as it can be a hard to diagnose condition due to its similarity with many other less serious complaints. The most common cause is a disc prolapse, but it may also be due to a tumour, an infection or a fracture in the spine. 

If you suspect you have CES, you should immediately go to A&E. 

Time is of the essence when CES is suspected – the longer the nerves are compressed, the more likely that damage will occur and result in bladder and bowel dysfunction. In extreme cases, untreated CES can lead to paralysis in one or both legs. 

What Are The Symptoms of CES?

  • Urinary Retention and Incontinence. This is the most important symptom. This refers to being unable to empty your bladder, or being unable to tell whether it’s full or not. This can lead to incontinence and not being able to tell when you are passing urine. You can also experience a loss of sensation in your bowels.  
  • Saddle Paresthesia. This refers to a loss of feeling in your ‘saddle’ region, eg. your genitals, buttocks and upper legs. It may also result in a ‘pins and needles’ feeling.  
  • Sexual dysfunction, including a loss of sensation.
  • Very severe lower back pain. 
  • Muscle weakness in one or both legs. 
  • Difficulty walking


CES is not life-threatening but it can permanently damage your body.

Thankfully it is extremely rare. The NHS estimates that CES occurs in one to three in every 100,000 people in the UK, but the British Association of Spine Surgeons estimates that it’s an even rarer problem, affecting between 6 and 10 people per million. 

Cauda Equina Syndrome is a rare but dangerous condition that it’s important to be aware of. If you would like more information, arrange a phone consultation with one of our chiropractors here in Brighton or visit the NHS website for more detail.