Early Symptoms of Cauda Equina Syndrome

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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 loss of sexual feeling, discomfort and/or altered sensation in both legs. Changes to bowel and bladder function (such as altered flow, sensation, or urgency to go to the toilet) are other red flags.

Here, the solicitors at JMW take a look at the causes, early symptoms and treatment 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. 

CES can affect anyone of any age and is considered a medical emergency. Relieving the condition requires urgent surgery and if healthcare professionals don’t recognise the signs or symptoms, or there is a delay in treatment, the condition can become permanent.


Cauda equina syndrome can present in one of two ways: either rapidly developing severe symptoms or slowly developing symptoms that get worse over time. Leg and foot numbness and weakness, bilateral sciatica, and bowel and bladder issues, including incontinence, retention, altered sensation or flow are all signs of rapid onset cauda equina syndrome. When that occurs, it is crucial to seek prompt medical assistance in order to address the cause  and maximise the potential of recovery.

Early symptoms can be intermittent and fluctuate in severity, making them difficult to distinguish from other types of back problems. 

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 anesthesia” - 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.  


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 MRI scan to diagnose the condition. A confirmed diagnosis will require emergency surgery.

Delays in seeing a doctor in hospital, the scan to confirm the diagnosis and 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’s vital that diagnosis and treatment are undertaken thoroughly and swiftly.

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.

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. 


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