The severity of cauda equina syndrome symptoms varies depending on the degree of nerve compression. For some patients, cauda equina syndrome (CES) develops suddenly while other patients experience a gradual onset of symptoms.

Symptoms of Cauda Equina Syndrome

Typical symptoms of cauda equina syndrome include:

Neurological symptoms in the lower body

Weakness, tingling, or numbness in the legs, and/or feet on one or both sides of the body is a common symptom. Lower body weakness or numbness may make it difficult to walk or stand.

See Leg Pain and Numbness: What Might These Symptoms Mean?

Altered sensation in the “saddle region,” or saddle anesthesia

The saddle region is the area of the body that would be in contact with a saddle when sitting on a horse. This region includes the groin, the buttocks and genitals, and the upper inner thighs. With cauda equina syndrome, all or parts of this region may have neurological symptoms of numbness, tingling, and/or weakness.


Bladder or bowel incontinence

Recent onset of bowel or bladder dysfunction, including incontinence and retention, is one of the primary red-flag symptoms of cauda equina syndrome. Bladder/bowel dysfunction typically consists of a poor urinary stream, an altered or lack of sensation while urinating, urinary retention, loss of rectal control, and/or the need to strain in order to urinate.

See When to Seek Medical Care for Low Back Pain

Sharp or stabbing pain in the legs or lower extremities

Compression of the cauda equina may lead to sciatic nerve pain felt on both sides of the body, and may be experienced as a sharp, hot pain felt down the backs of the thighs and possibly into the lower legs and feet.

Localized lower back pain

A dull, steady ache may be felt across the lower back and/or pelvis, potentially causing discomfort or stiffness.

Watch Causes of Lower Back Pain Video


Patients who experience any combination of the above symptoms should seek immediate medical treatment, as the condition can progress suddenly and requires prompt medical treatment.

Dr. Alan Villavicencio is a neurosurgeon and senior partner at Boulder Neurosurgical & Spine Associates, a private practice in Colorado. He specializes in complex spinal reconstructive surgery, spinal deformities, and minimally invasive surgery.