Emergency warning signs: numbness in the groin or inner thighs, new loss of bladder or bowel control, or rapidly worsening leg weakness. Call 911 or go to the nearest emergency department.
Overview
If you have back pain with numbness in the groin, buttocks or inner thighs, new trouble urinating or controlling your bladder or bowels, or rapidly worsening leg weakness, call 911 or go to the nearest emergency department now.
Cauda equina syndrome is a rare condition in which the bundle of nerve roots at the bottom of the spinal canal (the cauda equina) is severely compressed, most often by a large disc herniation. Prompt emergency surgery to relieve the pressure may help protect bladder, bowel, sexual and leg function.
Watch and learn
Video: “Cauda equina syndrome - a surgical emergency” from The Chartered Society of Physiotherapy on YouTube. It loads from youtube-nocookie.com only when you press play. Shown for general education; GSMC did not produce it. Watch on YouTube
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Symptoms
- Numbness in the “saddle” area (groin, buttocks, inner thighs)
- New difficulty starting urination, or loss of bladder or bowel control
- Severe or worsening leg weakness or numbness, often both legs
- Sexual dysfunction of new onset
- Back pain and sciatica (may be present)
Causes
- Large central lumbar disc herniation
- Severe spinal stenosis
- Fracture, tumor, infection or bleeding in the spinal canal
- Complications after spine surgery
How it is diagnosed
This is diagnosed in the emergency setting with a neurological exam and an urgent MRI.
Treatment options, step by step
A spine surgeon looks at the whole picture, including options short of surgery. Not every step applies to every person.
Self-care and lifestyle
Do not wait or try home treatment. Call 911.
Physical therapy and medications
Not applicable: this is a surgical emergency.
Injections and nerve blocks
Not applicable.
Minimally invasive procedures
Not applicable.
Surgical evaluation
Emergency decompression surgery, usually within hours of diagnosis.
Nonsurgical alternatives
Many spine problems are managed without surgery. See our nonsurgical options and holistic and lifestyle care guides.
Related surgeries
Call 732-202-3000 to confirm which surgeon performs this procedure and where.
When to seek urgent care
Call 911 or go to the emergency department for new or rapidly worsening weakness, numbness in the groin or inner thighs, loss of bladder or bowel control, or severe pain after a fall or accident.
Frequently asked questions
Should I call my doctor’s office first?
No. Call 911 or go to the emergency department. You can let us know afterward.
Is it common?
No, it is rare. But early treatment matters, so the warning signs are worth knowing.
Can it happen after a disc herniation I already have?
Yes. If you have a known disc problem and develop any warning signs, seek emergency care.
This page is general patient education and does not replace advice from your own clinician. Individual results vary.