New groin numbness or bladder trouble after back injury needs the ER
Why a spine surgeon and an emergency physician treat these symptoms as urgent
Nerves at the base of your spine help manage feeling in the groin, bladder, bowel and legs. When something presses hard on them, it’s called cauda equina syndrome. It is uncommon. But if treatment is delayed, the problems can last. [1, 2]
After a crash, don’t brush off new numbness around the genitals or anus. The same goes for losing the usual urge to urinate or having trouble starting to pee. New loss of bladder or bowel control also needs attention. [1, 2]
Don't wait on these changes
Go to an emergency room now if these symptoms are new or getting worse. It’s even more urgent if you also have back pain, leg pain or weakness. Tell the staff what time the change started. You don’t need to have every symptom. Do not wait to see if pain medicine or rest makes it go away. New, severe weakness in one or both legs also needs urgent care. [1, 2]
Say exactly what you feel
Talking about feeling in your genitals or using the toilet can feel awkward. Clear details help the team. Say whether you can feel the toilet paper when you wipe. Tell them whether your bladder feels full and if your urine starts normally. Mention any leaking you didn’t expect. [1, 2]
The team may test your strength and feeling and scan your bladder. They may order an urgent MRI when it’s appropriate. Other conditions can cause similar symptoms. So the team’s aim is to find or rule out dangerous pressure on the nerves fast. [1, 2]
Hold on to your return instructions
A good exam today can’t rule out a new problem tomorrow. If new symptoms show up after you leave, get urgent care again. Ask who will go over your test results with you. Find out what follow up you need if spinal compression is ruled out. [1]
Questions for the ER team
- Do my symptoms point to pressure on the nerves at the base of my spine?
- Do I need an urgent MRI or a bladder test?
- Which new symptom should bring me back?
Write down when each change began
Note when each change in your bladder, bowel or feeling first appeared. [1]
Sources and further reading
- 1North Bristol NHS, cauda equina emergency assessment
- 2American Association of Neurological Surgeons, cauda equina
This article is for general education from spine surgery and emergency medicine. New numbness in the saddle area, or new bladder or bowel changes, after a back injury need emergency care. This article can’t diagnose the cause.
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