It is not uncommon for cauda equina syndrome to be mistaken for sciatica in its early stages. GPs need to be aware that the underlying cause of the patient’s symptoms may have a far more sinister diagnosis.
Confusing sciatica and cauda equina syndrome
Early symptoms of cauda equina syndrome can appear to be similar to those of sciatica. If a patient attends their GP with pain in the back and buttocks as well as pain and tingling and/or numbness in one of their legs, they may be developing either of these conditions.
However, the causes of these conditions are not the same and their long-term effects are dramatically different.
Causes of sciatica and cauda equina syndrome
Sciatica is caused by the irritation of the sciatic nerve, the longest nerve in the body, which originates in the lower back and runs down through the leg to the foot. The irritation of this nerve can be caused by a variety of underlying conditions such as a slipped disc or spinal stenosis.
Whilst it can be painful and debilitating, the symptoms of sciatica do not extend to affect other regions of the body.
Cauda equina syndrome, on the other hand, whilst initially causing similar symptoms of leg pain and tingling can quickly deteriorate and cause permanent dysfunction of the bladder, bowel and sexual organs.
It is caused by compression of the cauda equina nerves in the lumbar region of the back and requires surgical decompression of the nerves to prevent devastating loss of function.
Diagnosis
It is vital, therefore, that a GP confronted with a patient who is suffering leg and buttock symptoms investigates whether there is evidence of any additional symptoms.
In these circumstances, the GP should check if the patient is experiencing any of the following:
- Loss of sensation in the saddle region
- Pain and tingling in both legs
- Weakness of ankle reflexes
- Loss of sensation around the anus
- Alteration of sensation when urinating
Any of these additional symptoms might suggest that the patient is, in fact, in the early stages of cauda equina syndrome and requires an emergency MRI scan to confirm a diagnosis.
Red Flag Warning
Should the patient currently be free of additional symptoms, a GP should advise the patient to be alert to any of the above ‘red flag’ symptoms and emphasise the need to attend A&E immediately should any of these symptoms start to develop.
Medical negligence
If a patient attending a GP with possible early symptoms of cauda equina syndrome is not checked for or warned of the red flag symptoms of this debilitating condition, the GP might be considered to have acted negligently.
If you or a loved one are suffering the appalling effects of permanent cauda equina syndrome because your early symptoms were misdiagnosed, contact us to discuss your experience with a specialist medical negligence solicitor.