What are the Cauda Equina Red Flags?

‘Red flags’ is a commonly used term for a set of symptoms that occur during the onset of Cauda Equina Syndrome. When they occur either as one or a combination of the symptoms below, they should lead a medical professional to suspect a diagnosis of Cauda Equina Syndrome. Red flags are extremely important as early recognition can lead to correct timely diagnosis and treatment. 

Treatment within 24 hours will almost always lead to the patient making a near or full recovery after surgery.

CES Made simple

Back pain and lower limb weakness

It is common to have a combination of back and leg pain as well as leg numbness or weakness. People who have a history of back problems may also have these symptoms but might not have Cauda Equina Syndrome.

Bowel disturbance

  • Constipation
  • Inability to stop a bowel movement
  • Loss of sensation when passing a bowel movement

Bladder disturbance

  • Inability to urinate
  • Difficulty initiating urination
  • Loss of sensation when you pass urine
  • Inability to stop or control urination
  • Loss of the full bladder sensation

Sexual problems

  • Inability to achieve an erection or ejaculate
  • Loss of sensation during intercourse
  • Loss of clitoral sensation

Saddle numbness

  • Loss of feeling between legs
  • Numbness in or around the back passage and / or genitals
  • Inability to feel toilet paper when wiping

Charity Film Awards 2022

We are very proud of our award winning charity film “24 hours changed my life – Forever.”

It won Silver in the Peoples choice award category in the Charity Film Awards 2022 and now we use it for presentations to patients, healthcare professionals and in our awareness campaigning.

The film highlights how time sensitive Cauda Equina syndrome is how important 24 hours can be for the long term outcomes of patients.

Stages of Cauda Equina Syndrome

Cauda Equina Syndrome occurs when there is continual and progressive damage to the nerve roots. It is a very serious condition that could lead to paralysis, so identifying the stages and seeking medical assistance as soon as possible is crucial.

CES – Suspected

Patients will have bilateral radicular pain, weakness or loss of reflexes and numbness or other abnormal sensations.

CES – Incomplete

Neurogenic urinary difficulties including altered sensation, loss of need to pass urine, poor stream of urine and straining in order to start urination.

CES – Retention

Painless urinary retention with overflow incontinence.

CES – Complete

Loss of cauda equina function, no perineal sensation, paralysed and insensate bladder and bowel.

You are not alone

The Cauda Equina Champions Charity is here to help with a wide range of free services to support people affected by Cauda Equina Syndrome.  Our services include:

Champions Connect Helpline

Online Support Group

CES Buddy Service

Funded psychological therapy services

CES legal advice

National support group meetings