Can Cauda Equina Come and Go? 

Cauda equina syndrome (CES) is a serious and highly debilitating form of spinal injury, which can lead to long-term disability if left untreated. In some cases, the symptoms of this condition will develop rapidly, but in other cases, the patient may experience a more gradual onset.

Because cauda equina syndrome is such a serious issue, if symptoms appear at any time it is always best to seek immediate medical attention urgently.

Here, we explain the most important symptoms of this rare but serious condition, as well as what it means if you believe these symptoms are coming and going.

What Are the Main Slow Onset Cauda Equina Symptoms?

Cauda equina syndrome is a condition in which the cauda equina nerves at the base of the spine are compressed, putting pressure on the nerve tissue in a way that causes long-term damage to them.

The cauda equina nerves play a key role in many of the most important functions in the pelvis and lower limbs, as well as the body's urinary, sexual and bowel functions. As such, people with cauda equina syndrome may experience the following symptoms:

• Severe low back pain
• Loss of bladder and bowel function, including bowel incontinence or a loss of sensation when passing urine or during a bowel movement, as well as hesitancy and constipation
• Problems with motor and sensory function, such as a loss of feeling or power in the lower limbs
• Altered sensation such as numbness or tingling (pins and needles) in the saddle area, genitals, legs or feet.
• Sexual dysfunction, such as impotence or a loss of sensation

There are several causes of cauda equina syndrome, such as a slipped disc placing pressure on the nerve roots, or spinal infections/tumours in the region of the lumbar spine. Mistakes made during spinal surgery can also be a cause of cauda equina syndrome. 

Many of the typical symptoms of cauda equina syndrome are similar to those of other conditions affecting the spinal cord, which is why they need to be assessed and properly diagnosed by a medical specialist as soon as possible.

What Does it Mean if Your Cauda Equina Symptoms Come and Go?

Cauda equina syndrome can develop in different ways, which will affect the way that the initial symptoms of the condition manifest.

In many cases, the individual will experience an acute onset of cauda equina symptoms, in which they will experience a sudden and rapid development of sensory and motor issues, or changes to their bowel or bladder function, over a period of 24 to 48 hours. These symptoms can become severe and long-lasting, and will not change without immediate surgical treatment.

In other instances, the patient will experience a gradual onset - where symptoms appear insignificant at first, but then progress over several weeks until the patient becomes severely incapacitated and has to be hospitalised.

Whichever form the onset of causa equina syndrome takes, the initial hours or days will see the patient experiencing “incomplete cauda equina syndrome”. Whilst in this stage, the condition is treatable, and surgery to decompress the nerves offers an opportunity for the patient to make a good recovery. 

How Does Cauda Equina Syndrome Impact Daily Life?

Cauda equina syndrome can cause a range of physical, emotional and psychological challenges, which vary depending on the severity of the condition and the effectiveness of medical intervention.

Loss of Mobility and Physical Independence

CES often results in partial or complete loss of motor function in the lower limbs, ranging from weakness to paralysis. This can make it difficult or impossible to walk, climb stairs, or perform tasks that require standing or balancing.

Many individuals require mobility aids such as walking frames, crutches or wheelchairs, which can limit their ability to navigate homes, workplaces or public spaces.

Bladder and Bowel Dysfunction

One of the most significant and distressing effects of CES is the loss of control over bladder and bowel function. Symptoms can include urinary incontinence, retention, or faecal incontinence, which may lead to embarrassment, reliance on catheters, or the need for specialised care.

These issues often require individuals to make substantial adjustments to their daily routines, including scheduling frequent bathroom breaks or wearing protective garments.

Chronic Pain and Sensory Changes

Many people with CES experience persistent back pain, sciatica, or sensory changes such as numbness or tingling in the legs, feet or buttocks. This pain can make it challenging to focus on work, hobbies, or social activities.

Sitting or lying for extended periods can also exacerbate discomfort, requiring individuals to seek out special furniture or cushions that provide the right support.

Sexual Dysfunction

CES often impacts sexual function, leading to a loss of sensation, erectile dysfunction, or difficulty achieving sexual pleasure. These changes can affect intimate relationships and lead to feelings of frustration, depression, or a loss of self-esteem.

Psychological Impact

The loss of physical independence and the challenges of managing CES symptoms can result in anxiety, depression, and a diminished quality of life. Individuals may struggle with feelings of isolation, especially if they are unable to engage in activities they previously enjoyed.

Employment and Financial Challenges

CES can require changes to a person’s work life. Jobs that require physical activity may no longer be possible, and even desk jobs can become difficult due to pain or the need for frequent breaks.

Some individuals may need to reduce their working hours, switch careers, or stop working altogether, resulting in financial strain and the need to apply for disability benefits or other forms of support.

Impact on Relationships

The physical and emotional toll of CES can put strain on personal relationships, as family members and partners may need to take on caregiving roles. Open communication and support are essential to maintaining strong bonds during this challenging time.

What to Do if You Have Symptoms of Cauda Equina Syndrome

If a person is experiencing any cauda equina syndrome symptoms - whether a gradual onset or an acute onset - it is essential that they attend A&E to be assessed as soon as possible. This may include a neurological examination or an emergency MRI (magnetic resonance imaging) scan to check the condition of the spinal nerves. 

By paying attention to these red flag symptoms, it will be possible for your doctors to diagnose cauda equina syndrome as early as possible, allowing you to undergo surgery to prevent the life-changing injuries that untreated cauda equina syndrome can cause.

What Are the Typical Outcomes of Legal Claims for Cauda Equina Symptoms?

Cauda equina compensation claims typically aim to achieve financial compensation for the harm caused by substandard medical care. This compensation is designed to help individuals rebuild their lives by covering the costs of treatment, support, and lifestyle adjustments necessitated by their condition.

Compensation typically includes:

• General damages: for pain, suffering, and loss of enjoyment of life caused by cauda equina syndrome.
• Special damages: to cover financial losses and expenses, such as:
• Loss of earnings (past and future)
• Medical expenses, including physiotherapy, counselling and ongoing care
• Costs for mobility aids or home modifications (e.g., ramps, stairlifts)
• Travel expenses for medical appointments or treatments

Many people who have been affected by cauda equina syndrome require lifelong assistance with daily activities due to mobility issues, chronic pain, or bowel and bladder dysfunction caused by cauda equina syndrome. Legal claims can secure funds for:

• Professional carers
• Personal assistants to help with daily tasks
• Rehabilitation and therapy services aimed at improving quality of life

Compensation claims also hold healthcare providers accountable for their actions. In the long term, this can lead to improvements in medical practices, ensuring better care for future patients.

Many cauda equina claims are resolved through negotiated settlements between the claimant and the defendant (e.g., an NHS trust or private healthcare provider). Settlements can offer quicker resolution without the stress of a court trial.

In rare cases where a settlement cannot be reached, the claim may proceed to court, where a judge will decide on the outcome.

The aim of a legal claim is to help individuals regain control over their lives. Compensation can enable access to resources and support that mitigate the impact of cauda equina syndrome, improving both physical and emotional wellbeing.

Browse our cauda equina case studies to read about cauda equina stories, and learn more about how we have secured considerable amounts of compensation for our cauda equina clients, leading to life-changing improvements to their quality of life.