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Cauda Equina
The Difference Between Sciatica and Cauda Equina Syndrome

The Difference Between Sciatica and Cauda Equina Syndrome

Sciatica and Cauda Equina Syndrome can present with very similar symptoms, including unbearable pain. Doctors sometimes mistake Cauda Equina Syndrome with Sciatica, often leading to devastating long-term consequences for the patient, including paralysis, permanent numbness and double incontinence.

Cauda Equina Syndrome is a medical emergency and must be treated, via surgery, within 48 hours (preferably sooner). Being sent home from a GP with a diagnosis of Sciatica when you actually have Cauda Equina Syndrome may result in you being able to make a claim for negligence against the doctor (or NHS Trust responsible for the practice or hospital).

Sciatica explained

Causes

Sciatica is a symptom caused by compression of the sciatic nerve in the lumbar spine or the pelvic region.

Common causes of Sciatica include:

  • a herniated or bulging disc in the spine
  • degenerative disc disease
  • Isthmic spondylolisthesis
  • Lumbar spinal stenosis
  • Piriformis syndrome
  • Sacroiliac joint dysfunction
  • pregnancy
  • muscle strain
  • spinal fracture
  • spinal tumour

Smoking and being very overweight can also increase the risk of Sciatica developing.

Symptoms

The symptoms of Sciatica can range from mildly irritating to completely debilitating. The most common symptom is sharp pain, starting in the lower back, then shooting down the leg.

Other signs of Sciatica include:

  • constant pain in only one side of the buttock or leg, but rarely in both sides
  • pain that originates in the low back or buttock and continues along the path of the sciatic nerve—down the back of the thigh and into the lower leg and foot
  • pain that feels better when patients lie down or are walking, but worsens when standing or sitting
  • pain typically described as sharp or searing, like an electric current
  • a "pins-and-needles" sensation, numbness or weakness, or a prickling sensation down the leg in some cases
  • weakness or numbness when moving the leg or foot
  • severe or shooting pain in one leg, making it difficult to stand up or walk
  • pain and other symptoms in the toes, depending on where the sciatic nerve is affected
  • lower back pain that, if experienced at all, is not as severe as leg pain

Treatment

The treatment for Sciatica depends on its severity. Non-surgical interventions include:

  • applying heat or ice to the leg
  • pain medication
  • epidural steroid injections
  • physiotherapy and exercise
  • massage therapy
  • acupuncture

Thankfully, Sciatica usually heals itself, with most people becoming free from symptoms within 6-12 weeks.

If the pain lasts longer than three months and is severe, surgery may be required.

Cauda Equina Syndrome

Causes

The most common causes of cauda equina syndrome are:

  • a severe ruptured disc in the lumbar area (the most common cause)
  • narrowing of the spinal canal (stenosis)
  • a spinal lesion or malignant tumour
  • a spinal infection, inflammation, haemorrhage, or fracture
  • a complication from a severe lumbar spine injury such as a car crash or fall
  • a birth defect such as an abnormal connection between blood vessels (arteriovenous malformation)

Symptoms

Cauda Equina Syndrome can be difficult to diagnose which is why medical professionals must take the utmost care when presented with any of the following symptoms:

  • an inability to control bowel or bladder functions – this can present itself as the inability to stop urine or faeces coming out or an inability to pass water and constipation
  • pain, numbness or weakness in both legs
  • severe lower back pain
  • sudden, unexplained impotency
  • loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet that is severe or gets worse over time

Treatment

Immediate surgery is required to remove pressure on the nerves. Surgery must be done quickly to prevent permanent damage, such as paralysis of the legs, loss of bladder and bowel control, sexual function, or other problems. It is best if this occurs within 48 hours of the onset of symptoms. You may also need high doses of corticosteroids to reduce swelling.

In summary

The symptoms of Sciatica and Cauda Equina Syndrome do cross-over; however, a medical professional should be able to tell the difference quickly, or recognise that further tests are needed to rule out the latter. If this is not done and you develop long-term complications from Cauda Equina Syndrome, then you may be able to claim compensation for negligence.

At Glynns Solicitors we have the expertise required to successfully act for people who have had cauda equina syndrome missed or misdiagnosed by a health professional. Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.

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