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Saddle Anaesthesia: A Red Flag Symptom

Saddle Anaesthesia

The final month’s Red Flag Signs and Symptoms awareness campaign looks at the red flag sign and symptom of saddle anaesthesia. In some circumstances a loss of feeling in the saddle area can be a sign of Cauda Equina Syndrome.

What do we mean by the “saddle area”?

The area of the buttocks, the perineum (the area between the anus and the scrotum or vulva) and the inner surfaces of the thighs.

Why is the saddle area affected?

The nerves at the end of the spinal cord (approximately just above the waist) are called Cauda Equina. These nerves are responsible for the supply of sensation to the skin around the bottom and back passage.

When the Cauda Equina nerves become compressed or squashed they can stop functioning. A loss of function can mean messages of physical sensation in the lower body do not reach the brain. This can potentially cause an individual to suffer from the problems explained below.

You can learn about the potential causes of Cauda Equina Syndrome on our website here.

What sort of problems do people experience with saddle anaesthesia?

Individuals may experience varying degrees of the following problems:

  • Loss of feeling between the legs;
  • Numbness in or around the back passage and / or genitals;
  • Inability to feel the toilet paper when wiping;
  • Tingling sensation in the saddle area;
  • Weakness in the saddle area.

Daz’s Story

Daz Hayden - Cauda Equina UK“I had sciatica symptoms for about a week and had never known pain like it. One Friday afternoon I noticed my saddle area had gone numb. I went to bed thinking it was just the zapain and amitriptyline tablets I was on. I woke up on Saturday morning, coughed and noticed urine came out. My wife luckily dragged me to Warrington A & E and I saw a junior doctor who carried out some tests. Three hours later I was transferred to Walton neurological hospital in Liverpool, underwent a scan and I was in the operating theatre by 9 o’clock that evening.

It’s now just over 10 months since this happened and I still have a weak right leg and numbness in my right bum cheek which travels all down the back of my right leg. I am getting stronger albeit slowly as each day passes. I have found that swimming and the gym help and I also do physio based pilates every week.”

What you should do if you experience saddle anaesthesia

Seek immediate medical care from your GP or nearest A&E department. They should be able to diagnose whether you are suffering from symptoms of cauda equina syndrome.

How is Cauda Equina Syndrome treated?

Cauda Equina Syndrome is a surgical emergency.

Surgery must be done quickly to prevent permanent damage. It is best if surgery occurs within 48 hours of the onset of symptoms. You might hear the surgical procedure being called a laminectomy. During a laminectomy part of the vertebra (called the lamina) is removed. The opens up the space surrounding the cauda equina nerves and relieves pressure on the cauda equina nerves.

There are several causes of cauda equina and depending on the cause of an individual’s CES, a patient may also require other treatment, including high doses of corticosteroids to reduce swelling, antibiotics if you are diagnosed with an infection, radiation or chemotherapy if a tumour was the cause.

Can saddle anaesthesia be reversed after surgery?

Everybody is different.

Some individuals may notice an improvement straightaway.

Some individuals may notice an improvement over a period of time – perhaps as long as two years or more.

Unfortunately, there are some individuals that may find the feeling in their saddle area does not improve fully or at all.

If surgery is received before an individual suffers from complete saddle anaesthesia, there is a better chance that the individual may recover some or all of the feeling in the saddle area.

If you would like to know more about any of the other red flag signs and symptoms please view our previous articles.