Back Pain and Cauda Equina Syndrome

Back pain is a health complaint that almost everyone has had at some point, whether they have felt it for a day or suffered it for several weeks. There are a myriad of statistics surrounding back pain, some claim that 9 out of 10 adults will suffer it at some point in their life while others claim that the proportion is 4 in 5 adults. Other statistics state that, in the United States, back pain is the fifth most common reason to visit a doctor. No matter which statistics are the most accurate, they all show that back pain is a concern for many people.

Pain in the back can be categorised in a number of ways. Often it is classified by the area that the pain is felt in - these categories are: neck pain, middle-back pain, lower-back pain and tailbone pain. The most common type that people are affected by is lower back pain. Alternately, the problem can be categorised by how long it lasts. Pain that lasts less than six weeks is known as 'acute', pain that lasts between six and twelve weeks is 'sub-acute', and 'chronic' pain is where it has lasted for longer than twelve weeks.

As there are so many different types of back pain there are also many different causes. The most common types of pain in the back are as a result of strain or stress on the spine. Putting stress and strain on your back is more easily done than you might think. Poor posture, either when standing, driving or sitting, is a central cause of back problems. Other causes may be lifting something awkwardly or incorrectly, not doing a warm-up/cool down when exercising or sleeping on a bad or broken mattress. Back problems can often be work related, such as resulting from sitting badly in front of a computer monitor all day or neck strain from tension in the neck muscles from emotional or physical stress.

Back pain can differ between people; in many cases one person's back pain can be completely different from another's. Some people may suffer short piercing bursts of pain while others may have to endure a constant dull ache. Some may find that the pain stays in one place while others have pain that moves to different areas. A large proportion of back related problems are not caused by serious illness, and will usually get better within twelve weeks. Patients are often prescribed painkillers to deal with the pain but there are other methods that may help. Heat therapy has been shown to help with pain, such as a hot bath or a hot water bottle but a cold compress may work just as well. Massage and specific exercises and stretches are also often recommended.

There can be a more serious underlying problem, however, if you find that you are having other symptoms as well as the back pain. If you are suffering from a fever or have had unexplained weight loss as well as a long lasting back pain, it is important that you discuss this with your GP. Other important symptoms may include swelling in the back, numbness in your saddle area or loss of bladder control. Other forms of back pain that may indicate a more serious problem could involve progressive weakness in the legs, back pain sustained after a car accident or fall, or back pain in patients who have a history of cancer.

One of the most severe health problems that can be caused by a serious back problem is Cauda Equina Syndrome (CES). This is a very rare, but very problematic, condition that usually results from direct trauma in the spine. The Cauda Equina is the bundle of nerves that are located in the base of the spinal cord that control lower limb sensation amongst other things. The Cauda Equina was named 'horse's tail' in Latin, by the anatomist Andreas Lazarius in the 17th century, because it appeared to resemble a horse's tail. Cauda Equina Syndrome is caused by the compression of these nerves and can cause long term health problems if it is not diagnosed or dealt with quickly enough.

Symptoms of CES can include loss of sensation in the legs, a numb sensation in the buttocks or bowel or bladder problems. The syndrome is often caused by compression or trauma to the Cauda Equina, for example through penetrative trauma, ballistic trauma, tumours or lesions, lumbar punctures, central disc prolapse or as a result of chronic spinal inflammatory conditions. CES can only be diagnosed through an MRI scan and once it has been diagnosed, immediate action should be taken. Medical negligence cases can arise from instances where there is a delay in diagnosis or treatment as the sufferer can end up with permanent damage to their health, such as problems with mobility or bladder/bowl dysfunction. CES is very rare, but should not be ignored if seemingly common back pain results in more serious symptoms.