Spinal Problems: Cauda Equina Syndrome

Cauda Equina affects the nerve roots that tail off from the spinal cord.  Symptoms of this syndrome can have a devastating and life changing impact.  Cauda equina syndrome is usually due to spinal disc damage that has been caused in the lower part of the spine called the lumbar region.  Damage may be caused by a single excessive strain or an injury which may have caused a herniated disc.

Symptoms can either occur very rapidly, or in the alternative may present in a slow manner – beginning as lower back pain that slowly progresses to difficulties in passing water or stools (or both!) when going to the toilet.  The severity of the symptoms depends on the degree of the compression to the spinal cord and where precisely the nerve roots are being compressed.

Luckily this is a rare disorder, however because it can be such a life changing condition, it is important to be aware of the red flags.  The reason why this is so important is because there is only a small window of opportunity to receive emergency treatment.  If this window of opportunity is missed it can potentially mean that the symptoms that may be affecting you, such as foot drop, incontinence, & numbness are irreversible.

  • Urinary retention: the most common symptom. The patient’s bladder fills with urine, but does not have the usual sensation or urge to urinate.
  • Urinary and/or faecal incontinence. The overfull bladder can result in incontinence of urine. Incontinence of stool can occur due to dysfunction of the anal sphincter.
  • Sensory disturbance, which can involve numbness in the ‘saddle’ area including the, genitals and buttock region.
  • Weakness or paralysis of usually more than one nerve root. The weakness can affect the lower extremities.
  • Pain in the back and/or legs (also known as sciatica).
  • Sexual dysfunction.

Any patient with any of these red flag symptoms should seek immediate medical attention.  Medical physical examinations, MRI & CT scans can identify whether Cauda Equina Syndrome is present.

Those experiencing any of the red flag symptoms should be evaluated by a neurosurgeon or orthopaedic spine surgeon as soon as possible. Prompt surgery is the best treatment for patients with this syndrome.



We at Grayston Solicitors specialise solely in Medical Negligence Law.  If you have concerns about the medical treatment that you or a loved one has received, including misdiagnosis or failure to treat Cauda Equina Syndrome, please contact us to see if we can help you in bringing a clinical negligence claim for compensation.  You can call us on 0151 645 0055 for an obligation-free chat.  If we are able to assist you we may be able to act for you on a No Win No Fee Agreement (Conditional Fee Agreement).





The Cauda Equina (horses’ tail) is a bundle of roots at the lower end of your spine which communicates with your brain and sends nerve signals back and forth regarding the sensory and motor functions of your lower limbs and the organs in your pelvic region.

Cauda Equina syndrome is very rare and is caused by nerves in the lower back suddenly becoming severely compressed. Symptoms include- sciatica on both sides, weakness, or numbness in both legs, numbing around genitals or anus and urinary retention/ incontinence (which is not usual for you). These symptoms can appear rapidly or over the course of several weeks/ months and CNS can be identified on an MRI, CT scan or Myelogram.

Cauda Equina syndrome requires emergency hospital admission and surgery to relieve the pressure on your nerves. It is very time sensitive and the best time to be treated is within 48 hours of the onset of your symptoms. The longer Cauda Equina is left untreated, the greater the chances are of permanent paralysis and incontinence, impaired bladder or bowel control, difficulty walking and other neurological/ physical problems.

If you undergo surgery to treat Cauda Equina and it has impacted your ability to walk you may need physical therapy, and you may be advised to see a specialist if you have any incontinence/ sexual dysfunction. For long term treatment you may be given certain medication for your pain management or for better bladder/bowel control.

Cauda Equina may lead to a medical negligence claim if any reported symptoms are missed, this can result in the necessary MRI scan or surgery being delayed. If this is the case, then Cauda Equina deteriorates, and the symptoms become permanent.

If you have concerns that you or a family member have received substandard medical treatment and an injury has been suffered as a direct consequence, we may be able to investigate a potential claim for you, please contact Graystons Solicitors on 0151 645 0055.  Alternatively, you can email and we can arrange to call you.


The BBC reported this week that due to resource shortages and a lack of awareness amongst medical staff, there are delays in diagnosing cauda equina syndrome.

 Cauda equina syndrome is a rare but very serious neurological condition which affects the bundle of nerve roots at the lower end of the spinal cord.

 Often the condition starts with nerve pain or a pins and needles sensation in the legs or bottom and whilst the condition is rare, if medical staff do not recognise the onset of the condition and act quickly to arrange urgent scans and surgery, there can be there are radical long-term consequences such as permanent paralysis and incontinence. Patients can also be left requiring future treatment and rehabilitation.

 NHS Resolution, who act on behalf of Hospitals in clinical negligence claims, advised this week that they were “working closely with Trusts and the wider NHS system to reduce avoidable harm to patients” and that they were sharing information between their Hospitals to highlight the warning signs related to cauda equina syndrome.

 If you have concerns about your diagnosis and management of Cauda Equina Syndrome, you may be eligible for compensation. One of our specialist clinical negligence lawyers would be happy to speak with you and advise you on your options, including a formal complaint and a legal claim, as well has how to fund a case and the possibility of a no win no fee arrangement (conditional fee agreement or CFA).