Cauda Equina Syndrome (CES)

Back pain is very common and although it can be painful and disabling, it rarely has serious medical consequences. On rare occasions, cauda equina syndrome can develop which can have more serious consequences and requires urgent medical attention

Cauda equina syndrome involves the compression of specific nerves which supply the bladder, bowel and groin area.

The purpose of this leaflet is to advise you on the potential signs and symptoms that you should be aware of. Any combination of these symptoms requires you to seek urgent medical attention. If you have any further questions, please discuss with your treating physiotherapist.


Below is a list of the potential signs and symptoms of cauda equina syndrome. If you develop any combination of these, please seek medical attention immediately or go directly to your local A&E.

  • Reduced sensation, pins and needles or numbness around your upper and inner thighs, genitals, back passage or buttocks.
  • Altered sensation when wiping yourself after using the toilet.
  • Difficulty controlling or stopping passing urine or loss of sensation as you pass urine.
  • Uncontrolled or unintentional leakage of urine.
  • Reduced feeling of if your bladder is full or empty.
  • Inability to control bowel movements or leakage of bowel contents.
  • Loss of sensation or loss of control during bowel motion.
  • Sexual dysfunction including inability to achieve erection or ejaculation, or loss of sensation around the genital area during sexual intercourse.
  • Reduced feelings of control in both your legs.

This can be difficult to diagnose as symptoms vary in intensity and can evolve slowly. Surgical intervention is often necessary to avoid permanent nerve damage. If you have any concerns we recommend seeking urgent medical attention.