Millions of people suffer from sciatica — nerve pain that radiates down the leg. In most cases, it is a painful but manageable condition. However, in rare instances, symptoms that seem like severe sciatica can actually be signs of Cauda Equina Syndrome (CES), a true spinal emergency that can lead to permanent paralysis if not treated immediately.
Distinguishing between severe sciatica and CES is one of the most critical jobs for any doctor evaluating a patient with back and leg pain. A failure to recognize the “red flag” symptoms of Cauda Equina Syndrome can constitute medical negligence and lead to devastating, lifelong consequences.
If you believe a doctor’s failure to diagnose CES led to a permanent injury, you may have a legal claim. Our firm has extensive experience in these specific cases. Learn more on our main Florida Cauda Equina Syndrome Lawyer page.
What Is Sciatica?
Sciatica is not a condition itself but rather a symptom of an underlying problem, usually a herniated disc or spinal stenosis that is irritating or compressing the sciatic nerve.
Key Characteristics of Sciatica:
- Pain Pattern: Typically a sharp, shooting or burning pain that radiates from the lower back or buttock down the back of one leg.
- Sensation: May be accompanied by numbness, tingling, or weakness in the affected leg or foot.
- Bladder/Bowel Function: Normal. This is a critical distinction. Standard sciatica does not affect bladder or bowel control.
While severe sciatica can be debilitating, it is generally not a surgical emergency and is often managed with physical therapy, medication and time.
What Is Cauda Equina Syndrome (CES)? A Spinal Emergency
Cauda Equina Syndrome occurs when the entire bundle of nerve roots at the bottom of the spinal cord (the “cauda equina”) is severely compressed. This compression cuts off function to the lower body and pelvic organs.
While CES is rare — affecting approximately 1 in 30,000 to 100,000 people annually — it represents one of the few true spinal emergencies. The rarity of the condition unfortunately contributes to missed or delayed diagnoses, as some healthcare providers may not immediately recognize the warning signs.
CES is a surgical emergency. Unlike sciatica, which affects a single nerve root, CES affects multiple, crucial nerve roots at once. Failure to perform emergency surgery to relieve the pressure, ideally within 24 hours, and no later than 48 hours, can result in permanent paralysis, incontinence, and other devastating outcomes.
The Critical “Red Flag” Symptoms: When It’s More Than Just Sciatica
This is the most important information to know. If you have back and leg pain accompanied by ANY of the following “red flag” symptoms, you must seek immediate emergency medical evaluation:
A Table Comparing Symptoms:
|
Symptom |
Standard Sciatica |
Cauda Equina Syndrome (Red Flag) |
|---|---|---|
|
Pain Location |
Typically radiates down one leg. |
Often affects both legs (“bilateral sciatica”). |
|
Numbness |
In the affected leg/foot. |
Saddle Anesthesia: Numbness in the buttocks, inner thighs, and groin area. |
|
Bladder Function |
Normal. |
Recent onset of dysfunction: Inability to urinate, loss of control, loss of sensation. |
|
Bowel Function |
Normal. |
Recent onset of dysfunction: Loss of bowel control. |
|
Sexual Function |
Typically unaffected. |
Recent onset of sexual dysfunction. |
|
Leg Weakness |
May occur in one leg. |
Often severe and progressive weakness in both legs, possibly leading to stumbling. |
Go to the Emergency Room Immediately If You Experience:
- Numbness in your buttocks, groin or inner thighs (saddle area)
- ANY new difficulty urinating, inability to feel when you need to urinate, or loss of bladder control
- ANY new loss of bowel control
- Weakness in BOTH legs
- Do not wait for a regular doctor’s appointment. Do not wait until morning. This is a medical emergency.
If you experience saddle anesthesia or any new problems with your bladder or bowel control, it is not sciatica — it is a medical emergency until proven otherwise.
When a Doctor’s Failure to Recognize Red Flags is Malpractice
A doctor evaluating a patient with severe back and leg pain has a duty to perform a thorough neurological exam and specifically ask about these red flag symptoms. A failure to do so, or dismissing these symptoms as “just bad sciatica,” can be a catastrophic breach of the standard of care.
Medical negligence in these cases often involves:
- Failing to ask about or document saddle anesthesia, bladder or bowel function.
- Dismissing a patient’s complaints of bladder/bowel issues without further investigation.
- Failing to order an emergency MRI when red flag symptoms are present.
- Delaying a referral to a neurosurgeon.
If a doctor’s failure to diagnose Cauda Equina Syndrome led to a delay in treatment and a permanent injury, you may be entitled to significant compensation. Lisa Levine is a nationally recognized attorney with extensive experience in CES cases resulting from diagnostic errors.
Suffered a Delayed Diagnosis of CES? Understand Your Rights.
If a doctor misdiagnosed your Cauda Equina Syndrome as sciatica and you suffered permanent harm as a result, you need to speak with an attorney who understands these specific, high-stakes cases.
Contact Lisa S. Levine, P.A. today for a free, confidential consultation. We will listen to your story, review the circumstances of your diagnosis, and advise you on your potential legal options.
Call Toll-Free: 954-256-1820
Or Explore Our Cauda Equina Syndrome Legal Services Page for More Information.