One of the early symptoms of cauda equina syndrome is lower back pain. Why is this and how should a GP react?
Back Pain
Back pain is unlikely to mean that someone has cauda equina syndrome. Back pain is extremely common whereas cauda equina syndrome is fairly rare.
Back pain can occur anywhere in the back and can be prompted by a wide variety of causes such as muscular pain or degeneration of the spine as well as injuries etc.
However, severe lower back pain can be an indication that the patient may be developing cauda equina syndrome.
Why does cauda equina syndrome cause back pain?
Cauda equina syndrome affects the patient’s sensation and movement in the lower body and is caused by compression of the cauda equina nerves.
The cauda equina nerves are located in the lumbar region of the spine at the base of the back. These nerves can become compressed or squashed due a number of conditions such as a herniated disc, a tumour on the spine, an abscess on the spine or infection of inflammation of the spine which can press against the nerves. All of these circumstances are likely to cause the patient to experience pain at that site.
In turn, the compression of the nerves will affect their ability to function effectively and begin to cause dysfunction in the lower body such as the legs and pelvic region.
Back pain as a sign of cauda equina syndrome
Severe lower back pain may, therefore, raise the possibility of cauda equina syndrome if the patient also begins to experience additional symptoms.
In the early stages of cauda equina syndrome, this is likely to be pain and tingling or weakness in one or both legs and buttocks. Such symptoms should suggest that the cause of the pain is due to nerve damage rather than, say, muscular strain.
This might prompt a medical practitioner to refer the patient for further investigation such as an MRI scan to ascertain the nature of the nerve problem.
Red Flag Warnings
If the GP or A&E professional decides that the patient’s symptoms do not warrant a referral at that stage, it is, nonetheless, imperative that the patient is advised of the red flag symptoms of cauda equina syndrome and told of the need to attend A&E as an emergency should those symptoms develop.
The symptoms to be alert to include the following:
- Difficulty with urinating or alteration of bladder sensation
- Loss of sensation between the legs and around the buttocks
- Loss of sexual sensation or movement
- Reduction in reflexes, e.g. the ankle
- If numbness and pain spreads from one leg to both
These symptoms increase the likelihood that the patient is developing cauda equina syndrome and this possibility needs to be ruled in or out urgently.
Should it prove that the patient’s symptoms are, in fact, due to compression of the cauda equina nerves, they may well require emergency surgery.
Medical Negligence
If a medical practitioner fails to recognise the possible significance of severe lower back pain in a patient who then develops cauda equina syndrome, they may be considered to have acted negligently.
If your cauda equina diagnosis and treatment were delayed due to a failure by your medical professionals to recognise key symptoms, you may be entitled to make a claim for compensation for your subsequent pain and suffering.
Here at Glynns Solicitors, we have supported numerous claims for cauda equina syndrome negligence and would be very happy to advise you.