Cauda Equina SyndromeThe term comes from Latin that means horse�s tail. The cauda equina forms the group of nerves that run through the lumbar spinal canal. Generally, the condition means two things:
- There is nerve compression of most of the lumbar spinal canal
- Compression symptoms like numbness or weakness in the leg/s
Sneaky PresentationOne of the major factors is long-term compression that individuals do not realize they have. Individuals are more likely to be aware of symptoms from another spinal condition before cauda equina syndrome presents. However, the condition presents quickly but often other overlapping back problems mask cauda equina syndrome.
CausesThe syndrome can be brought on from anything that compresses the nerves. Most commonly, it is a root compression from degenerative processes, specifically lumbar disc herniations. Other causes include:
- Bleeding like an epidural hematoma
- Trauma like fractures or penetrating trauma
- Tumors growing in the canal or the collapse of a tumor-affected bone
- Disc herniations can progressively grow in size, which leads to a slowly-evolving cauda equina syndrome.
- An enlarging disc herniation or synovial cyst can further compromise the already compressed nerves.
- Overgrowth of arthritic joints or bone spurs into the spinal canal can lead to long-term compression.
SymptomsThe symptoms vary based on the degree that the spinal canal has been affected:
- Back pain
- Leg pain
- Saddle numbness that extends into other areas of the legs
- Neurogenic bladder dysfunction. This can range from difficulty starting to urinate or limited and/or non-voluntary control urinating.
- Bowel dysfunction
- Sexual dysfunction
DiagnosisA doctor will examine any significant changes in bladder, bowel, or leg function that are considered red flags prompting an early and complete assessment. A physician will ask for a complete/detailed history of the onset and progression of symptoms. The second is a close physical examination which includes testing sensation and strength along with a rectal exam to assess voluntary contraction. Also checking the body’s reflexes, assess walking gait and alignment. If most or all of the symptoms are presenting this will set in motion spinal imaging or an MRI. If the symptoms, exam, and imaging match, it will lead to an emergency admission to the hospital.
Body Composition Spotlight
Obesity and Osteoarthritis ConnectionA variety of factors contribute to the development of osteoarthritis, including genetic factors and lifestyle choices. Research supports obesity is a significant risk factor in the development of osteoarthritis. It is pretty straightforward as body weight increases this equals increased load on the spine, and joints, especially the weight-bearing ones like the hips and knees. Increased pressure leads to early wearing, tearing, and eventual development of osteoarthritis. Added weight affects the body’s biomechanics and gait patterns. However, obesity has also been shown to be a risk factor even on the non-weight-bearing joints. This is based on adipose tissue, which is more than just insulation. Adipose tissue is metabolically active and is involved in the secreting adipokines and cytokines which promote an inflammatory response. Pro-inflammatory adipokines and cytokines can have detrimental effects on joint tissue including damage to cartilage, synovial joints, and subchondral bone. The effect of inflammation on the joints in the body can contribute to the development of osteoarthritis.
Dr. Alex Jimenez�s Blog Post DisclaimerThe scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at�915-850-0900. The provider(s) Licensed in Texas& New Mexico*
ReferencesCauses of Cauda Equina:�Neurosurgical Focus.�(June 2004) �Spinal epidural hematoma causing acute cauda equina syndrome��pubmed.ncbi.nlm.nih.gov/15202871/ Arriving at a Diagnosis:�British Journal of Neurosurgery. (August 2010) �Reliability of clinical assessment in diagnosing cauda equina syndrome��www.tandfonline.com/doi/abs/10.3109/02688697.2010.505987
The information herein on "Cauda Equina Syndrome Nerve Compression" is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional.
Our information scope is limited to Chiropractic, musculoskeletal, physical medicines, wellness, contributing etiological viscerosomatic disturbances within clinical presentations, associated somatovisceral reflex clinical dynamics, subluxation complexes, sensitive health issues, and/or functional medicine articles, topics, and discussions.
We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system.
Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*
Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.
We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez DC or contact us at 915-850-0900.
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Dr. Alex Jimenez DC, MSACP, CIFM*, IFMCP*, ATN*, CCST
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