What Is Saddle Paresthesia?
A set of severe sciatica symptoms are described in saddle paresthesia. These symptoms can occur in the buttocks, perineum, and groin. Sometimes, this condition is also referred to as saddle anesthesia. When there is a sensation of tingling and numbness in the affected area, the condition is called paresthesia.
Saddle means the areas of human anatomy that touch the saddle when a person is riding a horse. The lower groin, buttock region, and perineum are a part of the saddle. In these highly sensitive areas of human anatomy, there are chronic or intermittent sensations of pins or needles.
In saddle paresthesia, there is a loss of sensation in the upper part of the inner legs and the inner parts of the perineum and buttocks. Numbness and/or tingling is experienced in basically all the areas of the body that touch the saddle. Saddle paresthesia is also most likely a symptom of cauda equina syndrome, which is the compression of a bundle of nerve roots called cauda equina.
This condition can also be generated from certain types of pseudo-sciatica disorders. Rarely, the symptoms may exclusively exist. Moreover, most of the symptoms are accompanied by symptoms of sciatica, such as numbness, pain, weakness, and tingling in the lower body region.
Other problems such as incontinence may also result. This condition further causes poor coordination of the legs, incontinence, and contributes to weakness. When a medical imaging study is done, a spinal cord damage is often found. More information can also be obtained as to which specific nerve roots are involved.
The spinal cord can be decompressed by immediate surgery. Surgery is important so that permanent damage can be prevented. Proper recovery is very important after surgery. To redevelop strength and coordination, physical therapy is beneficial.
Causes of Saddle Paresthesia
One of the common sciatica symptoms is saddle paresthesia. The symptoms are most commonly experienced in the muscles of the foot, legs, or buttocks. These symptoms can occur unilaterally or bilaterally.
The buttocks are also affected by saddle paresthesia. However, the symptoms, in this case, are experienced in the centerline area and perineum, and not in the muscular anatomy. There are also people who experience saddle paresthesia in the groin and probably in the genitals.
This sciatica-related symptom is seen in cauda equina syndrome, wherein the lower lumbar and sacral spinal nerve roots are compressed within the central vertebral canal space. The symptoms usually vary from severe sciatica to saddle paresthesia, constipation, and incontinence depending on the degree of nerve root compression.
Other causes of paresthesia might also be due to the compression of the lower spinal cord in the lower thoracic and upper lumbar regions, which are delicate areas of the body. Saddle anesthesia that is spinally-motivated may be caused by extreme cervical spinal stenosis.
Typical symptoms of paresthesia are also experienced by many patients with dire canal impingement in the neck. These typical symptoms include paresthesia in the genitals, buttocks, perineum, and lower body expressions. These symptoms commonly happen in the elderly and in people who have recently undergone traumatic injury that enacts the stenotic changes.
Due to the following structural abnormalities, group compression of the lumbar and sacral nerve roots may occur in the lower back:
- Herniated disc
- Vertebral slippage condition
- Osteoarthritis process
- Atypical spinal curvature
- Congenitally narrow central vertebral canal
However, other possible causes may give rise to identical symptoms. The following are the possible causes:
- The spinal cord may get impinged due to central stenosis in the thoracic region, neck, or the upper lumbar spine. Diverse possible expressions may result, such as saddle specific anesthesia.
- The structures that innervate the saddle region may get victimized by neuromuscular disorders and this may result in dysfunction.
- Mind-body causation may give rise to saddle paresthesia, which includes psychogenic ischemia of the local nerves in the saddle region or the lumbosacral nerve roots.
- Some expressions of saddle paresthesia may occur due to nonspinal compression of the localized nerves. The muscular structures, cysts, or tumors, may impinge upon local nerves. Likewise, trauma may directly injure the nerves or symptoms may occur when the nerves suffer from disease-related reduced functionality.
Symptoms of Saddle Paresthesia
The subjective or objective numbness between the buttocks is the primary symptom of saddle paresthesia. This numbness is also often felt in the perineal region, and in the entire saddle region in some patients. This numbing feeling can be experienced in the inner part of the buttocks, which includes the lower groin, genitals, anus, and in the upper inner parts of both legs.
In other areas of the body, related neurological expressions may occur such as general sciatica, lower back pain, and dorsiflexion deficit in the foot.
Consequences of Saddle Paresthesia
In many cases, paresthesia can be subjective, which describes a tingling and numbness perception, although patients actually sense manual stimulation in the affected areas. Most patients describe the sensation as a dull and heavy feeling, which is often accompanied by regular or intermittent pins and needles.
The findings of paresthesia may also be objective. Intermittent sparks of neurological tingling are demonstrated by some patients yet many of the patients do not feel any sensation in the affected area. Patients often do not feel normal manual stimulation to a certain degree.
The following are the possible consequences regardless of the variety of paresthesia:
- The patient may have difficulty walking or standing because of incredibly weak or dysfunctional legs. There could also be coordination and balance problems in the legs.
- Urinary or fecal incontinence may be demonstrated by the patient. The person may experience urinary difficulty and/or fecal constipation.
- Regardless of gender, patients most likely suffer from sexual dysfunction. Sexual stimulation may not be felt by people, although they are able to physically perform.
- Inside the anal sphincters or genitals, intermittent or chronic deep pain may be experienced by the patient. This consequence commonly occurs along with paresthesia.
- Lingering effects of acute and chronic neurological compression may be experienced after successful treatment. Once the damage is permanent, the regeneration of neurological tissues rarely happens. For this reason, people with saddle paresthesia must be immediately evaluated and potentially treated by qualified health professionals.
Treatment for Saddle Paresthesia
In the vertebral anatomy, some sort of compressive neuropathy is involved in all instances of spinal motivated saddle paresthesia. Thus, the universal method by which the affected patient can be cared for is by performing a surgery. A comprehensive imaging study should be done to every area of the spine to properly diagnose the condition. It is also very important that all possible symptomatic zones can be pinpointed. It also becomes easier for healthcare providers to link or correlate the most logical root cause of the current expression. Once the diagnosis has been established, then treatment usually focuses on the surgical decompression of the nerve roots of the spinal cord or the spinal cord itself.
There are many factors on which the procedural selection will depend on. These factors include the location of the stenosis, operating physician, and the particulars of the specific case profile of the person. Surgical procedures such as corpectomy, foraminotomy, and laminectomy are various approaches that are most commonly utilized.
Spinal fusion is often done to treat many patients. Spinal fusion is also called as spondylodesis. In minor cases, the treatment may be nonsurgical, in which conservative or moderate care may be attempted. This includes spinal decompression using the DRX9000 decompression machine, other similar machines, or by chiropractic manipulation.
It is also important to keep in mind that spinal nerve compression is a serious issue and medical attention needs to be sought immediately. Make sure that your healthcare provider is aware of all your symptoms. Seek evaluation from an expert, such as a spine specialist as soon as possible.
Saddle Paresthesia Help
Saddle paresthesia is a condition that can be quite serious, especially if the root cause is neurological compression. If the nerve remains compressed for a prolonged period, functional impairment will be long-lasting along with a permanent set of symptoms. Although mind-body causation is the least serious, it still becomes a ground for a medical emergency.
The symptoms caused by saddle paresthesia disable the person to normally function and they can be incredibly disruptive, especially the symptom of incontinence. Thus, expert evaluation should be done by a qualified neurologist about any saddle location symptoms. In the case of spinal conditions, diagnostic testing should be done to determine any structural origin.
Patients should immediately seek medical care and should not delay the process since the risk of permanent neurological injury increases if it is left untreated. Surgery is usually recommended in cases of cauda equina syndrome. The chances of resolving terrible neurological expressions tend to increase when the diagnosis is correct and the patient can function either normal or near to normal.
It is difficult to diagnose disease-oriented or psychosomatic versions of saddle paresthesia. Also, their effective treatment is difficult. Proper identification is typically defined by mind-body variants, while the effectual therapy options for neuromuscular disorders are limited.
For some procedures around the groin area, anesthesia providers may recommend a saddle block. To facilitate delivery of a baby, the doctor has to cut into the perineum, which can be very painful. To keep the patient comfortable, anesthesia may be recommended for other procedures involving the perineum.