If you have been seeking medical help for bilateral sciatica, only to be diagnosed sometime later with cauda equina syndrome, you may be entitled to pursue a claim for compensation. Contact us today to find out more.
Bilateral sciatica
Bilateral sciatica is when there is a neural-type pain that runs from the lower back, down into both legs. This differs to unilateral sciatica, where the pain affects just one leg.
Bilateral sciatica may appear because the sciatic nerve is being irritated. However, it may also arise because the cauda equina nerves, located at the bottom of the spine, are being compressed. This is called cauda equina syndrome and is a medical emergency that requires immediate treatment.
Diagnosing cauda equina syndrome
Because of the risk of cauda equina syndrome, any patient presenting with bilateral sciatica requires a detailed assessment of sensory function which should then be recorded in the medical records. This should include an assessment of perianal, perineal and saddle sensation, as well as a digital rectal examination.
Bilateral sciatica is not regarded as a ‘red flag’ symptom of cauda equina syndrome, but is a cardinal feature of central sacral nerve root compression. As such, it ought to be considered a very significant symptom requiring a detailed assessment by a competent spinal practitioner.
A failure to carry out such an assessment in a patient who has ongoing bilateral sciatica represents a breach of duty. If a patient does indeed have cauda equina syndrome and this breach of duty results in a delay in diagnosis, there will be grounds for a medical negligence claim.
Concurrent symptoms
A patient with bilateral sciatica may also develop further symptoms. For example, a patient may report a change in bowel habit, most notably diarrhoea and watery stools. The development of altered bowel function is in keeping with central sacral nerve root irritation.
Pain relief medication can result in the side-effect of diarrhoea, but bilateral sciatic is certainly not a recognised side-effect of analgesics. Therefore a patient with both altered bowel habits and sciatica must undergo a detailed neurological examination.
Other symptoms that should prompt a neurological assessment include:
- Change in urinary habits – e.g. increased urgency
- Laxity of anal sphincters
- Numbness in the saddle area – including the perineum, buttocks and genital
Cauda equina syndrome and medical negligence
If a patient presents with a progressive history of back pain, sciatica and other symptoms associated with cauda equina syndrome, a competent clinician should make a timely diagnosis and arrange emergency treatment. A failure to do so will amount to a breach of duty. The patient in question will consequently be entitled to pursue a claim for compensation.