What are the most common cauda equina symptoms?
Cauda equina syndrome is usually accompanied by some recognisable symptoms which follow a particular pattern. Early on, people commonly experience a dull ache across the lower back. Weakness, tingling or numbness in the legs or feet is also a frequent symptom, together with difficulty in walking or standing.
Bowel or bladder symptoms are also very common signs of cauda equina syndrome developing. This may involve urinary retention (inability to urinate), incontinence of urine (being unable to control the urge), or just a lack of sensation whilst urinating. A loss of bowel control may also occur.
A symptom which is very distinctive is “saddle anaesthesia” – a feeling of lost or altered sensation in the part of the body which would be in touch with a saddle while sitting on a horse (groin, buttocks, genitals and inner thighs).
A further common symptom is a sharp or stabbing pain in the legs – usually down the back of the thighs and sometimes into the lower legs and feet.
The onset of cauda equina may be acute or gradual:
- In acute onset, sensory and motor deficits in the lower body may develop within 24 hours.
- In gradual onset, symptoms may come and go over a period of several months, with intermittent loss of control of bladder and bowels, in combination with muscle weakness, numbness and sciatica.
Do cauda equina symptoms differ between cases?
It is certainly not the case that every person with cauda equina syndrome complains of precisely the same symptoms. The condition does not follow the same course in every person. For example, not everybody with cauda equina syndrome has lower back pain.
What are the “red flag” symptoms of cauda equina syndrome?
Probably the real “red flag” symptoms – those which should be alerting any doctor to the likelihood of the syndrome – are those associated with urinating mentioned above (inability to urinate, loss of sensation while urinating, loss of control of the urge to urinate) and “saddle anaesthesia” ( the numbness or change in sensation around the groin, buttocks, genitals and inner thighs). Leg weakness, loss of sexual sensation or function and bowel disturbance (incontinence or loss of sensation) are also very important indicators.
How might I know that my cauda equina was caused by negligence?
Cauda equina syndrome can be caused by negligence in two main ways, either:
1 – an operation in close proximity to the spinal cord and/or the cauda equina nerves could have gone wrong and caused the syndrome to arise. If you have had an operation and have unexpectedly been left with symptoms of cauda equina syndrome you should be asking questions as to whether and how the operation has gone wrong.
2 – a delay by doctors to recognise the symptoms and treat the condition. Your GP should be recognising the “red flag” symptoms and treating you as a medical emergency. Any failure to act urgently may have been negligent. Similarly, even after admission to hospital there may have been negligent delay in carrying out the appropriate MRI scans of your spine, or in getting you into the operating theatre. It is crucial when treating cauda equina syndrome to decompress the affected nerves as quickly as possible, and any avoidable delay in doing so will be classified as negligent.