When Should You Go To The Er For Cauda Equina Syndrome
Cauda equina syndrome is a surgical emergency. Persons should seek immediate medical care or go to the emergency department if they believe they have symptoms of cauda equina syndrome. Some of the early symptoms related to cauda equina syndrome, including low back pain and muscle weakness, are more often caused by simple disk herniation, which does not require urgent attention. However, if you develop severe pain or loss of sensation or bowel or bladder disturbances, you should contact your physician immediately.
Your chances of regaining normal function and having a positive outcome are related to how long you have had symptoms of cauda equina syndrome. Most experts agree that people with cauda equina syndrome should undergo surgery to make more space for the nerves within 48 hours in order to have the best chance for complete recovery.
What Causes Cauda Equina Syndrome
Cauda equina syndrome is caused by significant narrowing of the spinal canal that compresses the nerve roots below the level of the spinal cord. Numerous causes of cauda equina syndrome have been reported, including traumatic injury, disk herniation, spinal stenosis, spinal tumors , such as metastatic tumors, meningiomas, schwannomas, and ependymomas, inflammatory conditions, infectious conditions, and accidental causes by medical intervention .
- Traumatic events leading to fracture or partial dislocation of the low back result in compression of the cauda equina.
- A collection of blood surrounding the nerves following trauma in the low back area can lead to compression of the cauda equina.
- Penetrating trauma can cause damage or compression of the cauda equina.
- A rare complication of spinal manipulation is partial dislocation of the low back that can cause cauda equina syndrome.
- Spinal stenosis is any narrowing of the normal front to back distance of the spinal canal.
- Narrowing of the spinal canal can be caused by a developmental abnormality or degenerative process.
- The abnormal forward slip of one vertebral body on another is called spondylolisthesis. Severe cases can cause a narrowing of the spinal canal and lead to cauda equina syndrome .
Accidental Medical Causes
- Lower extremity muscle weakness and loss of sensations
- Reduced or absent lower extremity reflexes
In This Video Dmx Displays Prolotherapy Before And After Treatments
- In this video, we are using a Digital Motion X-Ray to illustrate a complete resolution of a pinched nerve in the neck and accompanying symptoms of cervical radiculopathy.
- A before digital motion x-ray at 0:11
- At 0:18 the DMX reveals a completely closed neural foramina and a partially closed neural foramina
- At 0:34 DXM three months later after this patient had received two Prolotherapy treatments
- At 0:46 the previously completely closed neural foramina is now opening more, releasing pressure on the nerve
- At 1:00 another DMX two months later and after this patient had received four Prolotherapy treatments
- At 1:14 the previously completely closed neural foramina is now opening normally during motion
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Sciatica Symptoms That Require Immediate Medical Attention
While your sciatica pain can be severe and cause your leg to feel weak, the symptoms typically do not produce any long-term complications.1 Rarely, if the underlying cause of your sciatica becomes severe, it may produce troubling symptoms when your spinal nerve roots and/or spinal cord get compressed, sometimes triggering a medical emergency.
The symptoms of sciatica radiate from the lower back to the buttock, thigh, and leg. Common symptoms include pain, numbness, tingling, and/or weakness. Watch:Sciatica Causes and Symptoms Video
Below are the descriptions of two serious sciatica symptoms that must be urgently evaluated and treated:
What Can I Do To Prevent Lumbar Spinal Stenosis
Because almost everyone has some osteoarthritis of the spine by age 50, you cant really prevent lumbar spinal stenosis. But you may be able to lower your risk. Here are some ways to keep your spine healthy:
- Get regular exercise. Exercise strengthens the muscles that support your lower back and helps keep your spine flexible. Aerobic exercises like walking, swimming, cycling, and weight training are all good for your back.
- Maintain good posture. Learn how to safely lift heavy objects. Also, sleep on a firm mattress and sit in a chair that supports the natural curves of your back.
- Maintain a healthy weight. Excess weight puts more stress on your back and can contribute to developing symptoms of lumbar spinal stenosis.
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Can Bladder Cancer Cause Decreased Appetite And Weight Loss
The symptoms of decreased appetite and weight loss are more common among patients who are diagnosed with advanced or metastatic bladder cancer than it is in patients with bladder cancer diagnosed at an early stage.
If you experience the symptoms of decreased appetite and weight loss, talk with your healthcare provider so you can work together to diagnose and treat the cause. This is particularly important if you have seen blood in your urine or if you have experienced other problems or changes related to urination that can be caused by bladder cancer, such as:
- Urinating more frequently than usual
- Feeling pain or burning before, during, or after urination
- Needing to urinate urgently even though your bladder is not full
- Being unable to urinate even when your bladder is full
When Should To Call My Healthcare Provider
Lumbar spinal stenosis can cause cauda equine syndrome, which needs medical attention right away. Call your healthcare provider if you have:
- Loss of bowel or bladder control
- Severe or increasing numbness between your legs, inner thighs, or back of your legs
- Severe pain and weakness that spreads into one or both legs, making it hard to walk or get out of a chair
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Managing Low Back Pain And Incontinence
If youre experiencing back pain, incontinence, or even both, go speak to your doctor. They may be able to rule out any serious conditions contributing to the issues and they can put together a proper treatment plan.
In some cases, incontinence can be treated and with physical therapy to relieve pain and Kegel exercises to strengthen pelvic floor muscles may go away over time. In other cases, incontinence can only be managed.
Lifestyle changes can be beneficial for assisting with both back pain and incontinence symptoms. Try to become more active, with at least 30 minutes of moderate exercise about three times a week. Try swimming, riding a bike, or simply even walking to get moving.
Also, a healthy diet to relieve pressure on your digestive tract. Caffeine, items high in sugar, spicy foods, and alcohol can increase incontinence symptoms. Try adding more water, fruits, vegetables, and whole grains to your diet to relieve constipation and pressure on the bladder. The added nutrition may help with your low back pain as well.
Spinal Disorders And Neurogenic Bladder Dysfunction
Often times spinal disorders associated with injuries that result in nerve damage are linked to Neurogenic Bladder Disorder , which refers to urination issues. Neurogenic is a term for the nerve tissues that stimulate an organ or muscle to properly function.
With NBD the nerves that control the bladder and other muscles involved with urination may cause the bladder to be under or overactive.
When the nerves for bladder sensation or function become irritated, inflamed, or compressed, dysfunctions such as frequent urination, the sudden overwhelming urge to urinate, or involuntarily voiding the bladder may occur.
NBD is commonly caused by spinal cord injuries . Accidents that cause bruising or constrict blood flow along the spinal cord can damage the ability to transmit nerve signals.
Herniated discs, infections, lesions, lumbar tumors, and fractures along the spine can also cause back pain and damage to the spinal nerves leading to bladder dysfunction. These conditions may also cause Cauda Equina Syndrome , a serious medical issue requiring immediate attention.
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Spine Disorders With Potential To Cause Nbd
- Spinal Cord Injury is a common cause of neurogenic bladder dysfunction. The spinal cord need not be severed to cause paralysis below the injured level of the spine . Bruising of the spinal cord or inadequate blood flow can damage the cord’s ability to transmit nerve signals.
- Cauda Equina Syndrome occurs when the spinal nerve roots in the lower back are compressed. Although cauda equina syndrome is a rare occurrence, it is a serious medical situation requiring urgent care.
Causes of CES include:
Back Pain And Incontinence In Women
Depending on the cause of back pain or incontinence, symptoms may vary. Women often struggle with stress incontinence after giving birth and leak while participating in activities that add stress to the bladder, such as laughing, sneezing, or lifting a heavy object. However, kidney problems such as stones can also cause frequent urination or urge incontinence when the urge to urinate suddenly strikes.
While studies show that in some patients the cause of back pain and incontinence is linked to weight gain or sedentary lifestyles, both conditions can also be caused by chronic illnesses like type 2 diabetes and arthritis.
When it comes to giving birth, 50% of women report stress urinary incontinence. Postpartum back pain and incontinence may impact moms for up to twelve months after their babies are delivered due to pelvic floor weakness.
Pelvic floor muscles often become weakened due to the added stress of supporting a growing infant and from supporting the body during labor. Once weakened, pelvic floor muscles are less able to function under increased pressure from the abdominal muscles during physical activities, leading to leaks. Pelvic floor muscles also play a role in spinal stability.
There Is A Connection Between Urinary Problems And Cervical Neck Pain The Vagus Nerve And Blood Pressure
If you look at the illustration above you will see where the Vagus nerve is closely related to the C1 C2 C3 vertebrae. While doctors usually discuss the vagus nerve in singular sense, there are two vagus nerves, one on each side of the neck and in combination they are referred to as the vagal nerves. This means that the degenerative damage in your neck can significantly impact the function of one or both vagus nerves.
There has been some degree of controversy as to whether or not the vagus nerves do provide nerve impulses and function to the bladder. It should not be far fetched to think they do. The vagus helps regulate your heartbeat, the vagus helps regulate your breathing, your vagus regulates functions of your digestive tract. Wouldnt it be within the realm of possibility that the vagus could also regulate the bladder? Lets get to the science so we may be able to explain how treating your neck pain can, among other things, help regulate your bladder.
We are going to go back to a 1987 study performed on dogs, that makes a connection to neck area pain, the heart, and urinary bladder problems. If your neck pain includes problems of regulating heartbeat, you may find a long-sought answer to some of your problems.
Here are the highlights:
What did the researchers find?
- It is concluded that distension of the urinary bladder results in the response of a decrease in activity in efferent cardiac vagal nerve fibres .
What does this mean to you?
Can Back Pain And Incontinence Be The Result Of Another Condition
Though rare, one disorder that could cause back pain and UI is cauda equina syndrome . CES affects the bundle of nerve roots at the end of your spinal cord. These nerve roots send and receive signals from your brain and control the lower half of your body and your pelvic organs.
When the nerve roots are compressed, the pressure cuts off sensation and control. The nerves that control your bladder and bowels are particularly susceptible to the loss of control caused by this disorder.
A ruptured disc may also put pressure on the nerve roots. This disc and the pressure on the nerve roots can lead to back pain.
And, a form of arthritis called ankylosing spondylitis may cause back pain. This condition causes inflammation in your spinal joints. The inflammation can lead to discomfort and chronic severe pain.
How Is Ui Diagnosed
The only way to diagnose the underlying cause of both back pain and UI is to see your doctor and receive a full medical exam. The exam can help your doctor decide whether your symptoms are related to a separate condition that needs attention.
During the exam, its important you detail any symptoms, when you experience them, and how you relieve them.
After this initial diagnosis phase, your doctor may order several tests. These tests may include imaging tests like X-rays and blood work. The tests can eliminate causes for your symptoms.
If your doctor cant reach a diagnosis, they may refer you to a urologist or a back pain specialist.
Treatment for back pain and UI relies on finding an underlying cause. Once you and your doctor understand whats causing your symptoms, you can develop a plan to manage your symptoms.
How Can I Prevent Back Pain And Frequent Urination
Some causes of back pain and frequent urination arent preventable. But you can minimize your risk for certain conditions and health concerns. For example, you can decrease your risks for urinary tract infections by wiping front to back after you use the bathroom. Drinking plenty of water can help flush bacteria through your body. Also, if you have a history of stones in the urinary tract, your doctor can help you identify foods and beverages in your diet as well as certain medications that may be contributing to stone formation.
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Lower Back Pain And Frequent Urination Signs And Symptoms
Aside from pain experienced in the lower back and more frequent urination, you may experience bloody or cloudy urine, a constant urge to urinate, pain that moves from the lower back to the groin, difficulty beginning urination or fully emptying the bladder, painful ejaculation, fever, nausea, and vomiting.
What Are The Different Types Of Bladder Control Loss
- Stress incontinence is caused by sudden pressure on the bladder. Exercise, sneezing, laughing, or heavy lifting may be just a few reasons for urine leakage. Younger and middle-aged women near or at menopause experience this most commonly.
- Urge incontinence happens when you are unable to hold on when you have an urge to urinate and cannot make it to the toilet. People with diabetes, stroke, MS, Alzheimers, and Parkinsons disease may have this problem.
- Overflow incontinence happens when the bladder is constantly full and cannot be completely emptied. An enlarged prostate blocking the urethra or a spinal cord injury may cause this condition.
- Functional incontinence may occur if you have a condition that prevents you from getting to the toilet in time. Arthritis or other disorders can keep you from being able to move quickly.
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Bowel And Bladder Dysfunction Diagnosis
The diagnosis of bowel bladder dysfunction that is caused by cauda equina syndrome is done so that the site where the compression is taking place is localized and the underlying cause can also be determined. Diagnostic tests like MRI scan, myelograph and CT scan are used to determine the mentioned factors.
Sacroiliac Joint Injuries And Pelvic Dysfunction
Sacroiliac joint injuries occur when the joints that connect the lower region of the spine to the hip bones undergo abnormal structural changesallowing spinal bones to rub together. In this case, the joint may become stiff and cause lower back and pelvic pain as well as coordination problems. On the other hand, the ligaments within the joint may gradually loosen due to hormonal changes , causing pelvic or back pain during movement.
Experiencing a hard fall on one side of the body can also lead to sacroiliac joint misalignment that results in persistent pain. This kind of injury may cause inflammation that leads to constant aches in the lower back, pelvis, buttocks, or even the upper thighs. Stiffness, looseness, or misalignment of the sacroiliac joint is often linked to pelvic dysfunction.
Pain associated with pelvic dysfunction may be felt while sitting, standing, or walking. It can also affect bladder control if its not properly addressed. Over time, sacroiliac joint issues and pelvic dysfunction can alter core muscle activation, making it hard to carry out normal daily activities.
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Causes Of Herniated Disc Incontinence
When a lumbar herniation compresses the cauda equina structure, many nerve roots can be impinged upon, affecting the entire lower body. Typically, when this occurs, the patient will have trouble walking, controlling their bowels or bladder and may also have a variety of other symptoms commonly associated with sciatica, including pain, tingling, numbness or weakness in the buttocks, genitals, legs and/or feet.
Spinal sources of incontinence are likely to produce wide ranging herniated disc symptoms, including the loss of bladder or bowel control. Patients who suffer a slow progressive loss of bladder or bowel function are unlikely to be suffering from symptoms which are disc-related.
Some progressive and slow developing incontinence concerns are rooted in processes which affect the bladder or bowels themselves, rather than the nerves which innervate these structures.
However, central spinal stenosis may bring on slow onset symptoms as the canal narrowing worsens. This is true regardless of where in the spine the stenosis resides.