Massage therapy · Kitchener–WaterlooCauda Equina Syndrome

Low back pain is relatively common. Millions of people are affected. In the majority of cases, back and leg pain goes away without surgery (AAOS, n.d.). In rare situations, back pain can be a sign of cauda equina syndrome, a condition that needs emergency surgery. People with this syndrome are admitted to hospital as a medical emergency.

Cauda equina syndrome is a rare disorder that is classified as a surgical emergency (AAOS, n.d.). In this syndrome, something squeezes (compresses) the nerve roots at the bottom of the spine. Fast treatment is needed to prevent lasting damage, which can include incontinence (loss of bladder or bowel control) and permanent weakness or paralysis of the legs (AAOS, n.d.; Aduri et al., 2026).

Cauda equina syndrome affects the bundle of nerve roots called the cauda equina (Latin for "horse's tail", because the nerves at the bottom of the spinal cord spread out much like a horse's tail). These nerve roots are found in the lumbar spine (lower back), below the end of the spinal cord. They send and receive messages to and from your legs, feet and pelvic organs (AAOS, n.d.).

Understanding the anatomy of the spinal cord involves

• The spinal cord usually ends at about the level of the first and second lumbar vertebrae (L1 and L2) (Aduri et al., 2026)
• The tapered lower end of the spinal cord is called the conus medullaris
• The cauda equina is the bundle of nerve roots that continues below the end of the spinal cord. These nerves supply the legs, the perineum (the area between the legs), the bladder and the bowel (Aduri et al., 2026)

1. Emergency Surgery

Emergency surgery is usually recommended to relieve the pressure on the nerves, so that the damage does not become permanent (AAOS, n.d.). The operation depends on the cause; for example, a surgeon may remove a herniated disc, bone fragments, a tumour or a blood clot. Even with fast treatment, some people do not recover full function, and surgery may not repair nerve damage that has already happened (AAOS, n.d.).