Located an the end of the spinal cord, the cauda equina, or “horse’s tail” is a grouping of nerve roots that help in the transmission of signals back and forth between the body and brain. In some people, their spinal cord becomes abnormally narrow at this spot, squeezing the cauda equina and causing the syndrome of the same name. This squeezing may be caused by a number of conditions, such as an infection or inflammation or from a disc rupture, tumor, spinal stenosis or some trauma to this area of the spine. Serious if left untreated, cauda equina may lead to incontinence, problems with movement and feeling and even paralysis.

Cauda equina syndrome has several symptoms, including pain in the lower back as well as in one or both legs that starts in the buttocks and moves down to the back of the thighs. Bowel and bladder problems are also known to occur with the syndrome, and sufferers may experience a loss of sensation and muscle strength in the groin area as well as in the lower extremities.

A diagnosis of cauda equina syndrome begins with a look at a patient’s medical history and a physical examination that tests sensation, strength, reflexes, stability and mobility in the affected area. X-rays, CT scans and MRI—in addition to other imaging techniques—may also aid in the diagnostic process.

Treatments for cauda equina syndrome vary slightly. If the condition is caused by inflammation due to ankylosing spondylitis, for instance, anti-inflammatory medication may be all that is needed. In many cases however, surgery to alleviate pressure on the affected nerve roots is necessary. And when the onset of cauda equina symptoms is acute, a physician may order surgical decompression to prevent ongoing and long-term damage. Treatment also depends on the underlying cause of the syndrome: for instance a laminectomy or a discectomy may be called for if a herniated disc is at the root of the problem, or chemotherapy may be necessary if a tumor is present.