The cauda equina is a bundle of nerve roots that extends from the bottom of the spinal cord. It is Latin for “horse’s tail.”

Has your physiotherapist ever asked you the following questions: Are you able to control your bladder and bowels? Are you having a hard time going to the bathroom? Is there any numbness or tingling in the genitals, buttocks, or inner thighs? Do you have any weakness, numbness or pain in your legs? They are most likely asking questions to help rule out the potential that you may have cauda equina syndrome or cord compression myelopathy. What are those conditions you ask? Let’s find out together.

Cauda equina syndrome (CES) is a serious medical condition where the nerves become compressed. It causes severe low back pain, numbness in the saddle region, leg weakness and loss of bladder and bowel control.

This condition occurs when there is trauma or a space occupying lesion, such as a tumor, haematoma, or lumbar disc herniation.

It is extremely important that CES is diagnosed quickly as delays in treatment can lead to permanent paralysis, incontinence and sexual dysfunction. Treatment consists of emergency surgery to relieve pressure on the nerves and is ideally performed within 48 hours.

Now let’s take a look at cord compression myelopathy. It is serious spinal cord injury from pressure on the spinal cord. It causes the following symptoms: clumsiness, numbness, weakness, balance issues and sometimes bowel and bladder dysfunction.

It is the result of compression on the spinal cord from degenerative changes, disc herniations, trauma or tumors. Degenerative changes are due to age-related wear and tear that narrows the spinal canal. With a herniated disc, the disc will bulge into the canal. An example of trauma would be a fracture.

Cord compression myelopathy is primarily diagnosed with an MRI. If mild, physiotherapy can help to reduce symptoms and slow down progression. With more advanced cases, surgery is needed for decompression to take pressure off the spinal cord.

Spinal decompression surgery takes pressure off the nerves and cord by creating space in the spinal canal. The most common procedure is called a laminectomy. In this operation, the surgeon will remove bone from the back of the vertebrae.

Physiotherapists are trained to ask the appropriate questions and complete the relevant tests to figure out if you have either of these serious spinal pathologies. They then will be able to refer you on to the appropriate specialists so that you can be treated properly. If surgery is required, they will then be able to help you with your post-op recovery. Check out Panther Sports Medicine for all of your physiotherapy needs!