Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Cauda equina syndrome is an uncommon compression of the nerves at the end of
the spinal cord within the spinal canal. The terminology, "cauda equina,"
literally means tail of horse and refers to the normal anatomy of the end of the
spinal cord in the low back where it divides into many bundles of nerve tracts
resembling a horse's tail. Compression of the spinal cord at this level can lead
to a number of typical symptoms of the syndrome (low back pain,
sciatica, saddle
sensory changes, bladder and
bowel incontinence, and lower extremity motor and
sensory loss).
Cauda equina syndrome can be caused by any condition that results in direct
irritation or pinching of the nerves at the end of the spinal cord. Causes of
cauda equina syndrome include herniation of lumbar intervertebral discs,
abnormal growths (tumor or cancer) adjacent to the lower spinal cord, localized
infection near the spinal cord (epidural abscess), and localized bleeding
(epidural hematoma) causing pressure on the spinal cord in the low back.
Localized lumbar tumors that can lead to cauda equine syndrome include
ependymomas, metastatic cancer, and Paget's disease of bone. Localized infection
near the spinal cord can be caused by staphylococcus bacteria, tuberculosis
bacteria (Mycobacterium tuberculosis from Pott's disease), and others.
Sciatica pain, caused by irritation of the sciatic nerve, typically radiates from the low back to behind the thigh to below the knee. Disc herniation is
Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis bacteria. Symptoms include weakness, fever, weight loss, night sweats and
There are many causes of back pain. Pain in the low back can relate to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and
A hematoma is a collection of blood that is outside a blood vessel. There are different areas where hematomas occur including the inside the skull, scalp,
Paget's disease is a chronic bone disorder due to irregular breakdown and formation of bone tissue. Symptoms of Paget's disease include bone pain, headaches
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Degenerative disc disease makes the disc more susceptible to herniation (rupture) which can lead to localized or radiating pain. The pain from degenerative
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing
There are many types of urinary incontinence (UI), which is the accidental leakage of urine. These types include stress incontinence, urge incontinence,
Millions of women suffer from urinary incontinence (UI). UI occurs twice as often in women as in men. There are many types of urinary incontinence: stress
Urinary incontinence in children (enuresis) is twice as common in boys as in girls and may occur during the daytime or nighttime. Nighttime urinary incontinence
Bowel or fecal incontinence refers to the loss of voluntary control of stool, or bowel movements. The condition can include partial incontinence, in which
