This leaflet answers common questions about cauda equina syndrome (CES). If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.

What is CES?

CES is a rare but serious spinal condition which affects a group of nerves called the cauda equina. These nerves are at the lowest point of your back and are responsible for:

  • controlling the legs 
  • controlling the bladder and bowels 
  • supplying sensation to the skin around the bottom and genital regions.  

The condition affects between one and three people in every 100,000.

CES can lead to permanent loss of bladder or bowel function, loss of sexual function, and lower limb paralysis. Early treatment before symptoms become severe can reduce the risk of permanent disability.

What are the symptoms?

Symptoms of CES include:

  • pain radiating down one or both legs and/or severe lower back pain (any combination, seek help immediately)
  • loss of feeling or pins and needles between your inner thighs or genitals
  • numbness in or around your bottom or buttocks
  • altered feeling when using toilet paper to wipe yourself
  • increasing difficulty when you try to urinate
  • increasing difficulty when you try to stop or control your flow of urine
  • loss of sensation when you pass urine
  • leaking urine or recent need to use pads
  • not knowing when your bladder is either full or empty
  • inability to stop a bowel movement or leaking
  • loss of sensation when you pass a bowel motion
  • change in ability to achieve an erection or ejaculate
  • loss of sensation in genitals during sexual intercourse.

What to do if you have symptoms

If you experience any combination of the symptoms above, you will need to go to your local emergency department (A&E) immediately. Taking this leaflet can help you to explain your symptoms.

If treated before symptoms become severe, it can reduce the risk of permanent disability.