Cauda Equina Syndrome: Raising Awareness to Avoid More Ruined Lives

29th September 2015 Clinical Negligence

It is perhaps a sad fact that there are illnesses or conditions with which we have become relatively familiar over the years because of the number of people that they affect and the publicity which that incidence is able to attract.

There are others, however, that are less well-known even if they are no less dramatic.

Cauda Equina Syndrome (CES for short), for example, is a condition arising from damage to the nerves at the base of the spine which can result in lingering pain, impaired mobility, incontinence and sexual dysfunction.

Despite the impact which it has on sufferers' lives, CES and other complaints like it gain little attention compared to cancer, dementia or strokes. In that respect, it might be considered a 'Cinderella condition'.

A lack of understanding not only means less exposure in newspapers and magazines or a reduced fund-raising capability for charities trying to support those forced to live with CES.

It means individuals, including clinicians, can miss signs that someone might be suffering from CES.

The consequences can be most unfortunate, all the more so given that patients can make a complete recovery if they receive prompt treatment.

One woman represented by JMW's Clinical Negligence team has received £925,000 in compensation after her CES symptoms were not picked up until it was too late.

Claire Thornber lost her business, her relationship and now lives in constant pain after signs that she was suffering from CES were not correctly treated as a medical emergency by radiographers at a private MRI scanning facility and the Royal Blackburn Hospital in 2010.

It meant that the kind of urgent surgery which is required within 24 hours in such circumstances was delayed.

She was left with difficulty walking, in constant pain and incontinent.

In many of the cases which I and my colleagues have handled, symptoms like those which Claire presented with are confused with another problem, such as sciatica, or dismissed.

I should point out that the proportion of people with Cauda Equina Syndrome is not insignificant. According to figures which JMW has obtained from the NHS, more than 400 people have taken similar action against hospitals for negligence in treating their CES over the last decade.

Add in those cases either brought against GPs or in which no negligence was established and there numbers become substantial.

There is, I would argue, no reason why doctors and nurses should not know information about CES, be able to quickly recognise its symptoms and treat them in a sufficiently timely manner as to avoid lives being ruined.

After we took up Claire's case, the East Lancashire Primary Care Trust admitted responsibility and has paid compensation which will enable her to afford accommodation and equipment to help her cope with her disabilities.

She has also set up the Cauda Equina Syndrome Association to raise awareness among the public and healthcare professionals about the condition in an attempt to prevent others suffering as she has.

It is one positive out of an unnecessary situation. Like Claire, I hope that her efforts are rewarded with a reduction in the number of new CES cases.

Having the condition better known but wreaking its devastating impact on fewer people is surely an objective which the NHS should share too.

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Eddie Jones is a Partner and Head of Department located in Manchesterin our Clinical Negligence department

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