Early Symptoms of Cauda Equina Syndrome
The cauda equina is the collection of nerve roots at the end of the spinal cord. Because these nerves regulate our bowel, bladder, sexual organs and lower limbs, when they are compressed, the affected person may experience serious problems. This condition is known as cauda equina syndrome (CES).
There are a number of symptoms, referred to as "red flags”, that appear when these nerves are compressed. The warning signs include bowel and bladder dysfunction (such as altered flow, sensation, or urgency to go to the toilet).Loss of sexual feeling, discomfort and/or altered sensation in both legs (such as pins and needles or pain) are other red flags.
It is useful to understand the first signs of the condition, as this can enable your doctor to diagnose cauda equina syndrome and begin treatment at once. Failure to treat CES as an urgent problem can lead to serious, long-term symptoms like a loss of bladder and bowel function, reduced motor and sensory function in the legs and, in the most serious cases, permanent paralysis.
Here, the solicitors at JMW take a look at the causes, early symptoms and treatment of cauda equina syndrome.
Causes of Cauda Equina Syndrome
Cauda equina syndrome has several potential causes, with the most common being a large central disc herniation (slipped disc) in the lower back. It can also be caused by a tumour, infection, fracture, or narrowing of the spinal canal.
Whether caused by a herniated disc, a problem with the spinal column, or something else, CES involves the nerve roots at the base of the spinal cord being compressed in a way that restricts their function. These nerves control the legs, the pelvic organs, and urinary and rectal functions. This means that CES can result in serious complications if left untreated.
While not a cause of CES by itself, one factor that often leads to more serious symptoms is a failure to treat the condition urgently. If healthcare professionals don't recognise the signs or symptoms, or there is a delay in treatment, the condition can become permanent. This means facing life-long symptoms like bladder dysfunction, bowel dysfunction, muscle weakness or paralysis, or permanent nerve damage.
CES can affect anyone of any age and is considered a medical emergency. Relieving the condition requires urgent lumbar decompression surgery to restore the compressed nerve roots and prevent permanent symptoms. You should seek immediate medical attention if you notice any of the early symptoms of cauda equina syndrome.
The Main Symptoms of Cauda Equina Syndrome
Cauda equina syndrome often starts with one or two red flags, which without treatment worsen over the coming days as the condition progresses, with more and more red flags becoming apparent. . The main symptoms of cauda equina syndrome that indicate onset include:
- Leg and foot numbness and weakness
- Bilateral sciatica
- Bowel and bladder issues, including:
- Incontinence;
- Urinary retention; or
- Altered sensation or flow.
- Lumbar spine pain or leg pain
When these red flag symptoms occur, it is crucial to seek prompt medical assistance in order to address the cause and maximise the potential of recovery.
What Are the First Signs of Cauda Equina Syndrome?
The cause of pressure on the cauda equina can develop gradually, such as from a lumbar disc that is progressively displaced or a tumour that is growing. At other times, the onset of the pressure can happen suddenly when lifting, making a quick and sudden movement, or even sneezing.
Early symptoms can include:
- Lower limb weakness and intermittent changes in sensation, such as numbness or pins and needles.
- “Saddle anaesthesia” - loss or diminished sensation in areas where a person would sit on a saddle
- Urinary and/or bowel problems, such as not having any urge to go, incontinence, altered sensation when going, or altered flow
- Unexplained sexual dysfunctions, such as erection problems or loss of sensation
These symptoms can be confused with other conditions, meaning cauda equina can be misdiagnosed and patients sent away with medications for urinary infections and back pain.
Treatment for Cauda Equina Syndrome
If a person sees a healthcare professional with cauda equina syndrome symptoms, a comprehensive assessment of the patient must be undertaken. This can include an emergency magnetic resonance imaging (MRI) scan to diagnose the condition. A confirmed diagnosis through the MRI will require emergency surgery.
Delays in seeing a doctor in hospital, or delays in undergoing the scan to confirm the diagnosis and receive surgery, can lead to life-changing injuries for the patient. Permanent damage can include:
- Bladder and bowel incontinence
- Sexual dysfunction
- Mobility issues
- Chronic pain
All of these can have a severe impact on quality of life for many patients and their families, so it is vital that diagnosis and treatment are undertaken thoroughly and swiftly. Following surgery, patients might need physical therapy and other long-term treatments to restore bladder and bowel control or sexual function, or to combat leg weakness or paralysis.
What if Cauda Equina Syndrome Was Caused by Medical Negligence?
Many disc herniations are treated effectively by doctors and do not result in cauda equina syndrome or long-term symptoms. However, when medical staff fail to act and address CES symptoms properly, the results can be devastating.
If you have experienced delays or below-standard treatment for CES, and it was the result of negligence by a GP, hospital doctor, nurse, or physiotherapist, you may be entitled to medical negligence compensation. This can help to pay for the support you will need to deal with the condition, including physiotherapy, medical devices, adjustments to your home, or other needs.
JMW Solicitors has helped countless people get the compensation they deserve following cauda equina clinical negligence. If you or a loved one has been affected by cauda equina syndrome that was caused by negligence, our team of specialist solicitors is here to help.
Contact us today on 0345 872 6666, or fill out our online contact form, and we will get in touch with you about making a cauda equina syndrome claim.
