Spine Emergency Warning Signs

Why I gave you this sheet

Most spine problems are not emergencies, and most can be sorted out at a normal office visit. But a few warning signs can mean a nerve emergency — most importantly a condition called cauda equina syndrome, where the bundle of nerves at the bottom of the spine is suddenly compressed. These are uncommon, but when they happen, getting care quickly protects your function. I would rather you know them and never need them.

Call 911 or go to an emergency room if you have

• New trouble controlling your bladder or bowels — either leaking, or being unable to go
• Numbness in the area that would touch a saddle: the groin, the buttocks, or the inner thighs
• New or quickly worsening weakness in one or both legs
• Numbness or weakness that is spreading or affecting both legs

Also call the office promptly for

• Severe pain that is not controlled by your usual measures
• Fever with new or worsening back or neck pain
• After a fall or injury: new weakness, numbness, or severe pain

What to do

Do not wait to see if the emergency signs pass. For the bladder, bowel, or saddle-numbness symptoms, or rapidly worsening leg weakness, go to the nearest emergency room or call 911 — with these, hours can matter. Bring this sheet and your imaging information if you have it. For the “call the office” items, reach out the same day.

The science — for the curious

The reason cauda equina symptoms are treated as a true emergency is that the nerves controlling the bladder, bowel, and legs tolerate sustained pressure poorly — relieving it quickly gives the best chance of full recovery, while delay risks lasting problems. The same urgency applies to rapidly progressing weakness or cord compression anywhere in the spine. These situations are rare, but recognizing them early is one of the most important things you can do for yourself.

Learn more

OrthoInfo — Sciatica: orthoinfo.aaos.org

OrthoInfo — Lumbar Spinal Stenosis: orthoinfo.aaos.org

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic. If anything here does not match what we talked about, what we talked about wins — please ask me.