Cauda Equina Syndrome and Physiotherapy Negligence

If a physiotherapist fails to refer a patient displaying the obvious symptoms of cauda equina syndrome, there may be a case of negligence. To find out more, please get in touch with us today.

Back pain referrals

A large number of people suffer with generalised back pain, and quite often a GP will refer a patient to a physiotherapist. This can be very beneficial for those who require spinal manipulation in order to ease their symptoms.

However, a small percentage of patients will in fact be suffering from a more serious condition called cauda equina syndrome. This is when the nerves at the bottom of the spine are compressed and damaged.

A GP may initially overlook a diagnosis of cauda equina syndrome, as the early symptoms are very similar to generalised back pain – namely lower back pain and sciatica. A GP may therefore believe a referral to a physiotherapist is entirely reasonable.

Physiotherapist treatment

Nevertheless, cauda equina syndrome is a condition which progresses very quickly. Further symptoms will soon develop, including numbness in the genitals, buttocks and perineum (known collectively as the ‘saddle area’).

It is the job of a physiotherapist to note these symptoms, and to recognise whether or not a patient’s condition is deteriorating. If a patient does acknowledge saddle anaesthesia and bladder/bowel dysfunction, it should be recorded in great detail on an assessment form.

The physiotherapist must then test the loss of sensation in the saddle area – something which is mandatory in these circumstances. He/she should also establish if a patient is displaying other signs of cauda equina compression, such as difficulty passing urine.

Urgent referral to hospital

In cauda equina syndrome, leg pain and neurological symptoms are caused by compression of spinal nerve roots. Physiotherapy cannot address such nerve root compression. This means that all types of spinal manipulation are contra-indicated where there is any concern about compromise of the cauda equina nerve roots.

Thus if there is any concern about a patient’s symptoms, the physiotherapist should arrange for an immediate investigation with lumbar spine MRI scanning, or at least an immediate referral to a spinal surgeon.

This referral should come with a documented report from the physiotherapist, highlighting a patient’s symptoms and stressing that these are sufficient to raise concerns over cauda equina compression.

Medical negligence claims

If a physiotherapist fails to appreciate the relevance of a patient’s symptoms, causing a delay in the diagnosis and treatment of cauda equina syndrome, the standard of care will be deemed unacceptable. A patient may be able to pursue a claim for the damage this has caused.

To find out more about claiming compensation for cauda equina syndrome, please contact us today.

Please call us free on 0800 234 3300, from a mobile click to call 01275 334030 or complete our Free Online Enquiry for a no cost, no obligation opinion.

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