Cauda equina syndrome (CES) is a severe medical condition caused by injury to the nerves at the end of the spinal cord. If CES is not diagnosed and treated very quickly, it can cause permanent damage, affecting your health and quality of life.
Some of the red flag symptoms of cauda equina syndrome include severe back pain, incontinence, pain in one or both legs and sexual dysfunction. Doctors must be able to recognise these warning signs and immediately perform spinal decompression surgery.
If treatment is delayed, you may suffer permanent complications such as lower body paralysis, loss of bladder, bowel and sexual function, motor weakness or sensory loss. These may severely affect your ability to work and can lead to psychological trauma.
If your condition was caused or worsened by medical negligence, you might be able to make a cauda equina syndrome claim. You could recover damages for pain, suffering and all the related financial losses and expenses.
To find out if you are eligible for cauda equina compensation, please enter your details into our online claim form or call 0800 678 1410 to speak to a legal adviser. If your case is valid, you will be offered a no win no fee service so you can claim without any financial risk.
Can I make a cauda equina syndrome claim?
Cauda equina syndrome is a medical emergency, and the consequences of poor or delayed treatment can be very severe and debilitating. If you suffered permanent damage due to substandard medical care, you might be entitled to make a cauda equina claim.
The quickest and easiest way to find out whether your claim has merit is to contact a personal injury solicitor as soon as possible. If your case seems valid, they will investigate the circumstances of your injury and consult with a medical expert to prove that:
- Your doctor breached their duty of care towards you by providing a substandard level of care;
- The negligent medical care you received led to delayed treatment of your CES;
- You suffered a permanent injury and other related damages as a result.
If you have a valid cauda equina syndrome claim, your solicitor will guide you through all the steps of the claims process. This will include the following:
- They will help you gather relevant evidence to support your claim for cauda equina compensation, such as your medical records, witness statements, doctor’s notes and reports from independent experts in the field. You may also receive a free medical exam to assess the full extent of your injury and the long-term complications for which you could recover damages.
- They will send a letter of claim to the relevant NHS trust or private healthcare provider informing them of your allegations of negligence and your intention to make a cauda equina claim. While waiting for a response, your solicitor will work out a compensation award that reflects the injury’s effects on your life.
- If the other side accepts liability, your solicitor will negotiate a settlement on your behalf. If they do not accept the claim, you may have to issue court proceedings. However, it is unlikely that your case will go to trial as most claims are settled before that point.
If you are awarded cauda equina compensation, your solicitor can help you set up a personal injury trust if required. This will ensure that the settlement will not affect your eligibility for means-tested benefits or care contributions, and the funds will be safe from third parties.
What is cauda equina syndrome?
Cauda equina syndrome is a rare condition that affects a bundle of nerves at the end of the spinal cord known as cauda equina. These nerve roots provide motor and sensory function to and receive messages from the lower limbs and pelvic organs.
If these nerves are compressed due to trauma or a medical condition, it will affect the function of the bowel, bladder, sexual organs and lower limbs. This can cause pain in the lower body, paralysis, incontinence and other red flag symptoms that doctors should recognise and treat immediately.
Cauda equina syndrome affects around 2 in 100,000 people in the UK. Between 2010 and 2011, there were 981 surgical decompression surgeries in England, so there may be over 1,000 patients managed for CES in the UK each year.
The condition is not life-threatening, but if treatment is delayed, it can cause permanent damage to your body, including leg paralysis and loss of bowel and bladder function. There are two types of CES:
- Acute cauda equina syndrome is marked by a rapid onset of symptoms that often includes severe low back pain, incontinence and loss of bowel function. Sensory and motor deficits typically develop within 24 hours and cause permanent health problems if surgery is not performed within 48 hours.
- Chronic cauda equina syndrome is diagnosed in two situations:
- You have had symptoms for a long period before seeing a doctor;
- The surgery could not fix your nerve injury, and you suffered permanent damage.
Based on the degree of nerve damage, the condition can further be classified into:
- Complete cauda equina syndrome is characterised by painless urinary or bowel retention and overflow incontinence. It affects the majority of individuals with CES and also includes extensive or complete loss of sensation in the saddle and genital area.
- Incomplete cauda equina syndrome is defined by impaired bladder and bowel function, but the patient should still have some sensation or control.
The disabling nature of the condition can have life-changing and financially devastating effects on you and your family. If this was due to negligence, you might be able to make a cauda equina syndrome claim. Your solicitor will calculate a suitable compensation award to cover your pain, suffering and all the past and future financial losses you incurred because of your condition.
What are the symptoms of cauda equina syndrome?
Not every person will experience the same signs and symptoms of cauda equina syndrome. The condition may sometimes be hard to diagnose because symptoms may develop slowly and mimic other conditions. These include:
- Neurological symptoms in the lower body, such as weakness, tingling, numbness in one or both legs, and difficulty walking or standing; in severe cases, there may be paralysis in one or both legs.
- Saddle anaesthesia refers to altered sensation in the saddle region, the body area that includes the groin, buttocks, genitals and upper inner thighs, which may feel numb or tingling.
- Bladder or bowel incontinence or retention is one of the primary red-flag symptoms of cauda equina syndrome. Bladder or bowel dysfunction typically consists of poor urinary stream, loss of rectal control and trouble eliminating urine or waste.
- Sharp or stabbing pain in the lower back and legs, as the compression of the cauda equina may lead to sciatic nerve pain.
- Sudden onset of sexual dysfunction.
Severe back pain, incontinence, saddle anaesthesia and sexual dysfunction are the most important red flag signs that should prompt you to seek urgent medical care. Your doctor should recognise and treat these symptoms immediately; otherwise, they may be liable in a cauda equina claim.
To diagnose your condition, your doctor will:
- Investigate your medical history, asking questions about your overall health, activities, and when you first noticed the symptoms;
- Give you a physical exam to assess your strength, reflexes, mobility and sensations;
- Order imaging tests such as x-rays, MRI scans or CT scans to produce images of your spine and help assess the problem;
- Perform a myelogram, an imaging procedure that can reveal pressure points on the nerves or spinal cord.
Using these tests, your healthcare provider will be able to see the nerve roots, bones and spinal cord and diagnose cauda equina syndrome. If they fail to recognise the red flag symptoms and give you a misdiagnosis, causing you a permanent injury, you may be entitled to cauda equina compensation.
How is cauda equina treated?
Acute cauda equina syndrome needs immediate treatment to relieve pressure on nerves. Surgery should be performed within 48 hours of the onset of symptoms to prevent permanent damage, such as paralysis of the legs and loss of bladder control.
Depending on the cause of your condition, you may also need:
- High doses of corticosteroids to reduce swelling and inflammation
- Antibiotics, if you are diagnosed with an infection
- If a tumour is responsible for your symptoms, you may need radiation or chemotherapy
Even with treatment, you may not recover full function, depending on how much damage has already occurred. After a successful surgery, you may continue to recover bladder and bowel function over several years.
If permanent damage has occurred and your cauda equina syndrome becomes chronic, you will need to learn how to live with the condition. Besides physical and emotional support from your loved ones, you could also seek help from professionals like:
- Occupational or physical therapists
- Social workers
- Sex therapists
- Continence advisors or physiotherapists
Some general recommendations for managing the loss of bladder or bowel function include:
- Use a catheter to empty the bladder three or four times a day;
- Drink plenty of fluids and practice regular personal hygiene to prevent infections;
- Regularly check for waste and clear the bowels with gloved hands;
- Use enemas or glycerine suppositories if necessary;
- Wear protective pads and pants to prevent leaks;
- Ask your doctor about available medication for help with pain and bowel and bladder problems.
Misdiagnosis and delayed treatment can lead to permanent and irreversible damage and are valid reasons to bring a cauda equina syndrome claim. If you feel you are entitled to compensation, call 0800 678 1410 or request a call back to receive a free consultation with a legal adviser.
What can happen if cauda equina is not diagnosed or treated promptly?
Failure to diagnose and treat cauda equina syndrome can have severe and permanent consequences. To increase the chance of complete recovery, doctors should recognise the red flag symptoms and conduct the proper investigations to diagnose your condition.
Delayed treatment is not always the fault of medical professionals. If the patient sought medical advice too late, the nerves might have already been compressed for too long to be able to recover. However, if you received substandard treatment, you may be able to make a cauda equina syndrome claim.
The long-term or permanent effects of damage to the cauda equina include:
- Sciatic pain
- Bladder and bowel dysfunction
- Sexual dysfunction
- Total or partial paralysis of the lower limbs
- Sensory abnormalities in the lower body
- Muscle weakness in the lower body
Some common reasons for claiming cauda equina compensation include:
- Misdiagnosis is the most common reason for a claim. While most GPs and A&E doctors are aware of cauda equina and the need to immediately refer patients for further tests and surgery, some may let patients down by misdiagnosing the condition and failing to recommend proper action.
- Time is of the essence with cauda equina syndrome, but some patients may suffer delays of days or even weeks before they undergo a scan. If such delays occur, the damage could become permanent, and their lives can be turned upside down.
- GPs and medical staff may not be fully aware of the signs and symptoms of CES and its devastating impact on the patient’s life. Smaller hospitals may not be prepared to deal with a severe spinal injury that may need an urgent specialist referral.
- Inadequate or poorly performed surgery may lead to further compression of the spinal cord, causing a worsening of the condition. This can lead to additional interventions, which can be traumatic for patients and increase the risk of permanent damage.
- Failure to acknowledge postoperative complications after spinal cord surgery, such as blood clots or spinal epidural hematoma, may lead to cauda equina syndrome.
If you feel you may have received substandard care or treatment, call 0800 678 1410 or request a call back to receive a free consultation with a legal adviser. They can let you know if you are entitled to make a cauda equina claim and answer any questions you may have.
What are the leading causes of cauda equina syndrome?
Several causes may lead to nerve compression and cauda equina syndrome, including:
- Spinal birth defects, such as an abnormal connection between blood vessels
- A slipped, ruptured, or herniated lumbar disk is the most common cause
- Spinal anaesthesia
- Lumbar spinal stenosis, a narrowing of the spinal canal
- Infections of the spinal canal such as a spinal epidural abscess or meningitis
- Inflammatory conditions such as ankylosing spondylitis
- A severe lumbar spine injury due to a road accident, fall or violent injuries such as stabbing
- A spinal lesion or malignant tumour
- Postoperative complications from lumbar surgery
- Spinal haemorrhages
Although it may not be possible to prevent all the causes of CES, you could reduce the risk of suffering spinal disc herniation, which is the most common cause of the condition:
- Wear comfortable shoes and avoid high heels
- Stop smoking, as it may weaken your spinal disks
- Lift properly by bending your knees and keeping your back straight
- Maintain a good body posture to reduce strain on the spine
- Stretch regularly, especially after sitting for long periods
- Exercise to strengthen your back and abdominal muscles and keep a healthy weight
If you were diagnosed with cauda equina syndrome, you might be able to claim compensation for the pain, suffering and financial losses and expenses you incurred because of your condition.
How much compensation could I receive for cauda equina?
The amount of cauda equina compensation you might receive depends on the severity of your condition and how this has affected your life. As no two cases are the same, the compensation awards can vary considerably from one claim to another.
Your solicitor will consider all the effects of the injury to make sure you get the full compensation award you are entitled to. Every cauda equina syndrome claim covers two types of damages:
Special damages relate to past and future financial losses and expenses, such as:
- Cost of medical treatments and interventions
- Any modifications to your home or vehicle to accommodate your disability
- The care you received, even if provided by friends or family
- Lost wages due to taking time off work
- Loss of future earning capacity
- The cost of physical therapy or other therapies to help improve or relieve symptoms
- Aids or equipment needed to help manage the disability
- Transportation costs to and from the hospital
General damages relate to the physical injury and how it affected your life:
- Physical pain and suffering
- Mental and emotional trauma
- Physical impairment and disability
- Chronic pain and sexual dysfunction
- Loss of prospects and enjoyment of life
- Reduced quality of life
- The effect of the injury on your hobbies and social life
- Loss of consortium
- The wider effects on your family
The Judicial College offers guidelines that solicitors use to calculate a suitable cauda equina compensation award for general damages. According to them, you could receive:
- £2,150 to £10,970 for minor nerve injuries with complete recovery within several months to five years
- £10,000 to £24,340 for an injury to the ligaments and muscles causing back pain
- £25,000 to £34,000 for chronic pain, reduced mobility and irritation of the nerve roots
- £34,000 to £61,000 for disk lesions and fractures leading to long-term conditions causing continuing severe pain and discomfort
- £65,030 to £77,540 for complications such as nerve root damage, loss of sensation, impaired mobility and impaired bowel or bladder function
- £79,890 to £141,150 for the most severe injuries resulting in severe pain and partial or complete paralysis
- £34,000 to £62,000 for impaired sexual function
- £3,950 to £8,180 for minor post-traumatic stress disorder (PTSD) with virtually full recovery within a year or two
- £59,860 to £100,670 for very severe PTSD, where the effects of the trauma severely interfere with the victim’s ability to function
While no amount of compensation can take away what you have been through, it can help you recover as much of your independence as possible. To start a cauda equina syndrome claim, call 0800 678 1410 or request a call back to receive a free consultation with a legal adviser.
Can I claim cauda equina compensation using no win no fee?
No win no fee is the preferred choice of funding a cauda equina claim because it allows you to take legal action without running any financial risks. If your solicitor believes you have a fair chance of success, they will offer you a conditional fee agreement, which is the technical term for no win no fee.
This agreement removes the stress and worries of taking legal action by offering a series of unique advantages to claimants:
- You do not have to pay any upfront solicitor fees
- You get free legal advice and support throughout the claims process
- Your solicitor will help gather evidence and handle all the paperwork so you can focus on recovery
- They will know exactly how much compensation you are entitled to receive for your injury
- Your solicitor will contact the other side and conduct negotiations on your behalf
- If your cauda equina syndrome claim is unsuccessful, you do not pay anything to your solicitor
Furthermore, no win no fee claims usually involve taking out After the Event insurance before starting legal proceedings. This insurance policy covers all the legal costs and disbursements incurred during claiming if your case fails, such as:
- The defendant’s solicitor fees
- Court and counsel fees
- Medical reports
- Barrister and expert witness fees
- Costs of printing and copying
If you choose to claim on a no win no fee basis, you only pay anything if you win cauda equina compensation. The defendant will cover your solicitor’s fees and legal costs, and you will only have to pay:
- The cost of the ATE insurance premium;
- A success fee to your solicitor for winning your claim.
The success fee aims to compensate for the risk your solicitor took by offering you a no win no fee service. It cannot exceed 25% of your compensation for general damages and past financial losses and will be discussed and agreed upon from the beginning.
Is there a time limit to make a cauda equina syndrome claim?
The time limit to make a cauda equina claim is usually three years from the date of injury or diagnosis. If you do not take legal action before the claim limitation date, your case becomes statute-barred, and you can no longer claim cauda equina compensation.
Under section 33 of the Limitation Act 1980, the court has the authority to override the three-year time limit in certain circumstances where it would be reasonable to do so, based on:
- The length and reason for your delay
- The extent to which the delay has affected the strength of evidence
- Your conduct after the cause of action arose
- The steps you took to obtain expert advice
- How promptly and reasonably you acted after learning that you could claim compensation
There are several exceptions to the three-year time limit to bring a cauda equina claim:
- The three-year limitation does not apply to children, and a litigation friend, usually a parent, guardian or close family member, could claim on their behalf at any point before they turn 18. Afterwards, the victim has until their 21st birthday to make their own claim.
- The time limit to claim is suspended if the victim lacks the mental capacity to conduct legal proceedings. This could be due to a pre-existing condition such as a learning disability or PTSD and other psychiatric injuries caused by the cauda equina syndrome.
- If you received treatment abroad, you should still be able to claim compensation, but the time limit to make a claim can differ considerably from country to country and could be as short as one year.
In any case, you should contact a personal injury lawyer as soon as you are diagnosed. This will help your solicitor gather reliable evidence to support your cauda equina syndrome claim and secure the compensation you deserve. Furthermore, they could help you get access to private treatments that are not always available through the NHS.