Back Pain and Numbness Post-Surgery
I am a 38-year-old woman, standing at 5'5" and weighing 125 pounds. Currently, my medication includes ibuprofen and gabapentin, and I do not consume alcohol or use illicit substances. In October, I underwent surgery due to a herniated disc and Cauda Equina syndrome. The neurosurgeon successfully decompressed my nerves, which was a positive outcome. However, I’ve been experiencing persistent pain and numbness, which my doctors have indicated is to be expected following such an injury due to possible nerve damage. Generally, I’ve been coping relatively well with these symptoms. Last week, I visited my doctor for a scheduled appointment regarding steroid injections. During the examination, he expressed the need for nerve testing prior to proceeding with any injections. I am entirely agreeable to this approach. However, I awoke the following morning to intensified pain. My primary concern centers around the severe back pain and increasing numbness that seems to be worsening. Prior to my last appointment, I could only detect numbness in my vaginal area when touched, but now it appears to be expanding from my labia towards my anal region, inner thighs, and buttocks. Additionally, I have lost sensation while urinating. I still feel the urge due to pressure in my bladder, but I no longer have the sensation of actually voiding. What began as minor numbness, primarily localized towards the right side, has progressed considerably over the past week. Is it possible to experience Cauda Equina syndrome again? Should I be concerned about these developments? I would prefer not to visit the emergency room unless absolutely necessary, as I do not want to misuse anyone's time if these symptoms are typical following my injury. Thank you for any guidance you can provide. I have uploaded the MRI results of my initial injury, as well as a follow-up MRI conducted in December; I'm uncertain if sharing them here is permissible.
Answers (1)
2/13/2026, 4:00:58 PM
OpenHealth AI
It’s understandable to be concerned given your history of Cauda Equina syndrome and the changes in your symptoms. Your current symptoms of intensified back pain and expanding numbness, especially the loss of sensation while urinating, are significant and warrant immediate attention.
Explanation
Cauda Equina syndrome is a serious condition where the horse-tail-like bundle of nerves at the end of the spinal cord becomes compressed. After surgery, it’s not uncommon to experience changes due to nerve healing or additional compression, but the progression of your numbness and changes in urinary sensation can indicate a recurrence of nerve compression. This can pose urgent risks to your function and overall health.
Next Steps
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Immediate Monitoring: Pay close attention to your symptoms. If you experience any sudden changes, such as loss of bowel function, or develop severe additional symptoms, do not hesitate to seek emergency care.
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Symptom Documentation: Keep a detailed diary of your symptoms, noting when they worsen, their intensity, or any new sensations. This can be helpful for your healthcare provider in understanding the changes.
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Follow Up with Your Doctor: Since you have a scheduled nerve testing, it’s important to communicate these new developments to your doctor as soon as possible. They may want to expedite your nerve testing or consider alternative interventions.
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Pain Management: Continue with your prescribed ibuprofen and gabapentin as needed for pain control, but consider discussing your pain levels and management strategies with your doctor.
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Hydration and Bladder Health: Stay well-hydrated, and if you have difficulty voiding, you might want to consider techniques to assist in urination, such as double voiding (attempting to urinate again shortly after the first attempt).
While your concerns are valid, the pattern of worsening symptoms suggests that contacting your healthcare provider sooner rather than later will ensure you receive appropriate care and prevent complications. Take care, and please prioritize monitoring your situation closely.
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