Anyone who has experienced sciatica will be very familiar with the pain that can be experienced down the leg. Sometimes people report pain down both legs. This can happen on occasions but usually the pain alternates from one side to the other.

Pain down both legs at the same time is a ‘red flag’ and is potentially a serious condition called Cauda Equina. This is a rare condition and unlikely to afflict most people.

Although the symptoms from Cauda Equina have some overlap with general sciatica symptoms the causes are different and so is the risk to long-term health.

Cauda Equina is caused by compression of the nerves at the very bottom of the spine. The nerves at the bottom of the spine separate into lots of separate strands that look like a volumised horsetail, hence the Latin name Cauda Equina.

There can be several reasons for the compression of the Cauda Equina. Common reasons are;

• Trauma – that can lead to fracture or dislocation in the spine
• Spinal disc herniation
• Spinal stenosis
• Tumour
• Infection – that affects the nerves
• Inflammatory conditions

If left untreated it can lead to serious neurological conditions such as incontinence and potentially some paralysis.

Symptoms of Cauda Equina

• Low back pain
• Sciatica
• Leg pain – down one or commonly both legs
• Leg muscle weakness and loss of sensations
• Numbness in the groin or area of contact if sitting on a saddle
• Bowel and bladder disturbances
• Inability to urinate
• Decreased sensation while urinating
• Inability to stop or control urination
• Constipation

The symptoms do overlap with more general sciatica symptoms. The key take away to note is the symptoms linked to toilet habits.

Any change in toilet habits while experiencing sciatica symptoms is a red flag and needs to be assessed by a healthcare professional if these symptoms persist for more than 24 hours, as lumbar decompression surgery may be required.