"I'm Having Trouble Urinating..." — Cauda Equina Warning Signs You Shouldn't Miss

Most spinal stenosis is nothing to panic about. These symptoms are the exception: if you have them, go to a hospital right away.

This column describes urgent symptoms. If you have any of the signs below, don't wait to see whether they pass. Get medical care right away.

Throughout this series, I've asked you to stay calm and learn the facts. Most lumbar spinal stenosis is something you can live with over the long term.

Very rarely, though, there is a situation that needs urgent care: cauda equina syndrome, the subject of this week's column. I'm not trying to scare you. Knowing how to recognize it is a kind of insurance, in case you ever need it.

An older person who has noticed a worrying symptom calmly phoning for advice So you can act calmly if it ever happens.

Symptoms That Mean See a Doctor Right Away

Be on alert if any of these come on suddenly:

  • Difficulty urinating, being unable to start, or leaking urine
  • Leaking stool, or a feeling that your anus won't close properly
  • Reduced feeling in the buttocks and inner thighs, the parts that touch a seat (a saddle-shaped area)
  • Weakness in both legs, or numbness that spreads quickly

These can be signs that the bundle of nerves (the cauda equina) is being severely compressed. If it's left untreated, recovery can become difficult, so early treatment, including surgery, may be needed.

Not Sure Whether It's Serious?

Not every bladder change is an emergency. Going to the bathroom more often lately, or finding it a little harder to pass urine, often has another cause, such as age or the prostate.

What matters is whether it came on suddenly and is clearly different from your usual. In particular, if problems with urination or bowel movements show up at the same time as numbness or weakness in your legs, don't hesitate: see a doctor.

If you're not sure, go anyway, just to be safe. If you're told everything is fine, you'll at least have peace of mind.

Summary

  • Most spinal stenosis is something you can live with, without panic
  • The exception is when problems with urination or bowel movements come together with sudden leg weakness or numbness
  • This can be a sign of cauda equina syndrome and needs prompt treatment
  • If in doubt, get checked to be safe. Don't wait too long to see whether it passes

I wrote this column so that, in the rare case it happens, you and your family can act calmly.