It is not unusual for cauda equina syndrome to be wrongly diagnosed in the early stages. This is because the symptoms mimic other conditions, and it is not until complete urinary retention occurs that doctors realise the actual cause.
Recognising cauda equina syndrome
At the base of the spine sits a bundle of nerves called the cauda equina. These spread from the bottom of the spine, down through the pelvis, buttocks and upper legs. They enable function and sensation in the lower half of the body, including the feet, legs, rectum, perineum, genitals and pelvic organs (including the bladder and bowel).
Compression of the cauda equina causes the blood supply to be restricted, and it is for this reason that the nerves become injured. Function and sensation will subsequently deteriorate, providing a physical indication that the cauda equina nerves are being compressed. These symptoms should act as a warning sign to medical professionals, alerting them to the possibility of cauda equina syndrome.
The ‘red flag symptoms’ of cauda equina syndrome include:-
- Severe lower back pain which often comes on very suddenly
- Bladder dysfunction, which often includes the need to strain when urinating, increased frequency and lack of sensation in the urethra
- Numbness/pins and needles in the peri-anal area
- Reduced anal tone, which may lead to incontinence
Examples of misdiagnoses
Sadly, medical professionals do not always recognise these red flag symptoms, instead believing them to be indicative of another, more minor condition. Because of this error, a patient is not sent for an MRI scan, which would reveal the presence of spinal nerve compression.
The most common misdiagnosis is generalised lower back pain. Indeed, many people in the UK suffer from lower back pain, and in the majority of cases this is not caused by cauda equina syndrome. Therefore it can be that medical professionals simply diagnose generalised back pain without considering the possibility of cauda equina syndrome.
Other examples of misdiagnoses include spinal stenosis, sciatica, urinary tract infections and even being overweight.
Delayed diagnosis
A delay in diagnosing cauda equina syndrome will prove devastating. Indeed, if the nerves are not decompressed, the damage will become increasingly severe until function and sensation is lost altogether. Once a patient develops complete urinary retention (where there is no bladder control), the damage will be permanent. A patient will then be left with long-term neurological complications of a life-changing nature.
If you or your loved one has suffered because cauda equina syndrome was wrongly diagnosed, please get in touch with us today to discuss your options.