Fix my Spine

With Iona Collins

Underactive bladder function in association with sciatica?

You may have symptoms of Cauda Equina Syndrome…

“Cauda What?” I hear you ask. The Cauda Equina (horse’s tail in Latin, which is of no significance to us) describes the nerves in the spine which run through the lower back, or lumbar spine and sacrum. The rest of the spine houses the spinal cord, with the head holding the brain.

The nerves which are called the Cauda Equina provide function to our legs, bladder, bowel and sexual function. So, if something were to happen to the Cauda Equina, we would experience problems with the function of these parts of us, to a greater or lesser degree.

If the nerves to the bladder, bowel and sexual organs are damaged in the lumbar spine or sacrum, the resulting problem with function tends to be related to less activity. So, we may not notice when we need to empty our bladder, because the usual urgency when we are full is no longer there. When we empty our bladders, it can take a while to get started and then, our usual satisfying gush is reduced to a rather disappointing trickle. At the end of our weeing episode, rather than finishing up with a sudden stop, the trickle just gradually peters out and we may feel that we haven’t emptied our bladders fully, necessitating another trip to the loo shortly afterwards.

We may feel that we don’t open our bowels as regul-arly. We may also wonder whether we’re getting older, since our wonderful sexual function (and sensation) is not as wonderful anymore. When we add in a bad back and some leg pain, we can feel pretty miserable.

When these sort of symptoms creep up on us gradually, we may not even realise that they can all be related to a problem in the lower back. When the symptoms happen quickly, it tends to be easier to see that the severe leg pains and inability to use the loo properly may be related. Cauda Equina syndrome is treated as a surgical emergency. This is because the continence issues associated with back problems don’t always recover, even when the back is treated prompt-ly. By contrast, severe sciatica pain tends to go away by itself and if it is treated with spinal surgery, the pain usually gets better.

In 2016, the Society of British Neurological Surgeons produced a publically-accessible document on Cauda Equina syndrome (CES for short), which is available on the right hand side of the webpage found on this link: I think that this part of the document below is useful:

There are many different causes of CES, with one of the commonest causes being large slipped discs, or disc protrusions. The vast majority of slipped discs, however, do not cause CES. Slipped discs are very, very common and most of us will experience sciatica at some point in our lives. It’s important to under-stand when sciatica is something to treat with pain-killers while we focus on good posture and wait for the pain to settle down, versus proactively seeking urgent medical help, because our bladder/bowel/sexual function has noticeably changed.

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