New onset bowel/bladder dysfunction with back pain (Cauda Equina Syndrome") is a surgical emergency and a visit to the local hospital is warranted. This can be associated with saddle (perineal) numbness.
Chronic bowel/bladder dysfunction can be from a myriad of issues, but sometimes it is related to the nerves coming from the spine. These issues could have medical causes (multiple sclerosis, Guillain-Barre, diabetes, neuropathy, stroke, etc) or spine roots (disc herniation, bone spurs, stenosis, scoliosis, etc).
Think of a nerve being the telephone cable that transmits information from the spinal cord to a muscle/skin (it’s final destination). If this telephone cable is compressed anywhere along the route (disc herniation, stenosis, scoliosis, bone spurs, etc), dysfunction of the bowel/bladder can occur.
Diagnosis
The success of treatment options depend on an accurate diagnosis, using a combination of but not limited to: physical exam, x-ray, CT scan, MRI, diagnostic injections, and EMG investigation.
Treatment
Treatment options include therapy, strengthening, steroids, creams, anti-inflammatories, neuro-modulating medicine, muscle relaxants, injections, surgical decompression, surgical fusion, or surgical disc replacement. For new onset (<48 hours) of bowel/bladder dysfunction (cauda equina syndrome), emergent decompression is indicated. A custom treatment plan is recommended for each and every patient.