Cauda Equina Red Flags

27th July 2022 Clinical Negligence

Cauda equina describes the collection of nerve roots at the end of the spinal cord. These nerves are responsible for our bladder, bowels, sexual function and lower limbs, and if they are compressed, it can result in serious problems for sufferers. This is referred to as cauda equina syndrome (CES). 

There are a number of symptoms that occur when these nerves are compressed, which are referred to as ‘red flags’. The red flag signs are bowel and bladder disturbance (e.g. altered flow, sensation or urgency), altered sensation in the lower part of the body, pain and/or altered sensation in both legs and loss of sexual sensation.

In this blog post, we will run through what causes cauda equina syndrome, what the cauda equina red flags are and what happens if somebody presents with the red flags. 

Causes of cauda equina syndrome

Cauda equina syndrome has numerous potential causes, with the most common being a large central disc herniation (slipped disc) in the lower back.

CES can affect anyone of any age and is considered a medical emergency. Relieving the condition requires surgery within 24/48 hours, and if healthcare professionals don’t recognise the signs, or there is a delay in treatment, the condition can become permanent.

What are the cauda equina red flags?

The following red flags, or warning signs, can suggest you have CES. It is vital that you seek advice from a medical professional if you spot the warning signs early to try to avoid permanent damage to your body. 

The red flags related to CES can be broken down into five categories:

Bladder disturbance

  • Inablity to urinate
  • Difficulty urinating
  • Loss of sensation when passing urine
  • Inability to control urination
  • Loss of full sensation of the bladder
  • Incontinence

Bowel disturbance

  • Unable to stop a bowel movement
  • Constipation
  • Loss of sensation when passing a bowel motion

If you are usually able to control your trips to the toilet, but find that you are suddenly unable to control when you need to go, this may be caused by cauda equina syndrome. The damage caused by compression of the cauda equina nerves can cause you to have issues when going to the toilet.

Pain and weakness

  • Leg pain in both legs
  • Leg weakness or numbness in both legs
  • Tingling or pins and needles in both legs

Pain in the legs is often referred to as sciatica. Sciatica comes from the pain caused by a slipped disc. This can cause extreme discomfort and create unnecessary pressure on the spine. The torn disc can press on surrounding nerves, causing pain in the legs. 

The pain may bring with it tingling, pins and needles, numbness, or weakness in your legs. 

The most common characteristic of sciatica is pain that stems from the lower back, down into the buttocks and into the legs, often right down to the ankle. The pain can vary from tolerable to unbearable. Sciatica on both legs and buttocks can be a sign of cauda equina syndrome, so it is important that you seek urgent medical attention if you experience this. 

Sexual problems

  • Unable to achieve an erection or ejaculate
  • Loss of sensation during intercourse
  • Loss of clitoral sensation

Saddle numbness

  • Loss of feeling between the legs
  • Numbness in or around the genitals
  • Inability to feel the toilet paper when wiping

If your legs, genitals or anus feel weak or numb, this can be a sign of cauda equina syndrome. As the space around your cauda equina nerves is narrowing and compressing a section of nerve tissue, this can lead to nerve damage and leave you without the ability to control your lower body. 

The compression around your cauda equina nerves affects your legs and can leave you with numbness. If you feel that your legs are weak, or that you have lost feeling in areas of your legs, you should speak to a medical professional about the possibility of having cauda equina syndrome. 

As with the compression around the spinal nerves, the nerve damage can also be felt around or under your genitals, or around your anus. Again, this could be a sign that you have cauda equina syndrome and it is vital that you go to the hospital as quickly as possible to get this checked. 

What should happen if I attend hospital with cauda equina red flags

If a person presents with cauda equina red flags, a comprehensive assessment of the patient’s symptoms must be undertaken. This can include an emergency MRI scan to diagnose the condition. A confirmed diagnosis will require emergency surgery within 24 hours.

Delays to the assessment, scan and treatment can lead to life-changing injuries for the patient. These include:

  • Bladder and bowel incontinence
  • Sexual dysfunction
  • Mobility issues
  • Chronic pain
  • Chronic fatigue

All of these can have a severe impact on quality of life for many patients and their families.

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 even a 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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