Cauda Equina Syndrome: Warning Signs and Rehabilitation After Surgery

Act today if you notice these

If you have back pain or sciatica and develop any of the following, go to an emergency department now. Don't wait for a physiotherapy appointment.

• Numbness or altered feeling around the genitals, buttocks or inner thighs (the saddle area)
• New difficulty starting to pass urine, weak flow, or not knowing when your bladder is full
• Loss of bowel control or not sensing a bowel movement
• Sexual dysfunction that's new
• Sciatica in both legs, or rapidly worsening leg weakness

Outcomes are strongly linked to how quickly decompression surgery happens. Delay can leave permanent bladder, bowel and sexual function problems.

What causes it

The most common cause is a large central disc herniation in the lower back. Less often it follows spinal stenosis, tumours, infection or trauma. It's rare, but because disc problems are so common, we screen every back pain patient for these signs.

Rehabilitation after surgery

Recovery can take many months, and it varies a lot between people. Nerve function sometimes improves over one to two years. Physiotherapy addresses what's been affected:

Leg weakness and foot drop are treated with progressive strengthening, balance work and walking re-education, sometimes with an ankle-foot splint in the short term. Pelvic floor rehabilitation is often needed to support bladder and bowel control, together with the urology team. Sensory loss in the saddle area requires practical education around skin care and toileting routines.

The emotional side matters too. Many people feel anxious about their body after such a sudden event. Clear goals and steady, measurable progress help.

Exercises often used for Cauda Equina Syndrome

These are exercises our physiotherapists commonly include. Which ones suit you, how many and in what order depends on your assessment and stage of recovery.

All back and spine exercises

Frequently asked questions