Kayaking on a peaceful afternoon, Mandy Smith suddenly felt a sharp, stabbing pain in her back.
But what worried her more were the new, shooting pains radiating down the fronts of both her legs.
The moment she climbed out of her kayak, she was bent double, gasping for breath because of the overwhelming agony.
Mandy, now 51, had already seen her GP multiple times and tried physiotherapy, but her symptoms kept fluctuating.
This episode, however, was different — the pain was unbearable and relentless.
“I couldn’t even stand up straight or dress myself. Driving was impossible, and no painkillers helped,” she recalls.
Living in Liverpool with her husband Terry and their three sons, Mandy was desperate to understand what was happening.
Discovering a Hidden Danger: Cauda Equina Syndrome
Confused about the cause, Mandy initially blamed menopause or a muscle sprain.
It was only after talking to a nurse friend, who mentioned a rare emergency condition called cauda equina syndrome (CES), that Mandy began to connect the dots.
CES happens when the bundle of nerves at the lower end of the spinal cord — called the cauda equina — gets compressed.
With symptoms like leg pain and urinary urgency matching Mandy’s experience, her friend urged her to go to A&E immediately.
An MRI scan confirmed a slipped disc pressing on those critical nerves.
The surgeon warned that without urgent surgery, Mandy risked paralysis and loss of bladder control.
The emotional weight hit hard.
“Seeing Terry cry broke me down,” Mandy says, but she was lucky to get diagnosed quickly compared to others.
Martin’s Story: A Delay That Changed Everything
Martin Brown, a 44-year-old amateur world champion powerlifter, wasn’t as fortunate.
Seven years ago, while lifting a heavy deadlift at the gym, Martin suddenly lost feeling in his legs and collapsed.
Initially thinking it was a muscle tear, he soon experienced excruciating pain, tingling, and numbness spreading to his groin.
Despite calling for medical help, delays kept piling up. After hours waiting for an ambulance and being told to wait for an MRI, Martin’s pain worsened.
A Christmas holiday shut the insurer’s MRI service, and it took multiple trips back to A&E before he finally got scanned late at night.
The scan revealed a massive disc prolapse squeezing his spinal nerves.
Martin underwent emergency surgery but was told the damage might be permanent.
Years later, he still struggles with walking and bladder control, relying on a wheelchair for long trips and enemas for bowel movements.
His quality of life changed drastically.
Understanding Cauda Equina Syndrome: Why It’s an Emergency
CES is a true medical emergency because the cauda equina nerves control essential functions like bladder, bowel, and sexual function.
Symptoms often start with sciatica or lower back pain but quickly worsen to include:
- Difficulty starting to urinate or a weak urine stream
- Loss of sensation in the genital or anal area
- Weakness in both legs
- Loss of feeling when the rectum is full
- Sexual dysfunction
According to spinal surgeon Mike Hutton, sudden new symptoms within two weeks should prompt urgent medical evaluation.
Irfan Malik, a neurosurgeon, stresses that compressed nerves can lose blood supply and suffer irreversible damage if not treated immediately—ideally within hours.
Doctors use simple but crucial questions to spot CES: “Do you know when you need to pee? Can you feel yourself peeing? Does touching or wiping your genitals feel normal?”
Why Do Some Slipped Discs Cause CES?
Slipped discs are common and usually harmless, but only a few trigger CES.
Experts think it depends on factors like inflammation, the size of the spinal canal, and nerve blood flow.
CES is more frequent in women and can also result from spinal stenosis, tumors, infections, or major trauma like car accidents and sports injuries.
Diagnosis relies on MRI scans, but sadly, it’s often missed.
Nearly a quarter of legal claims against the NHS for spinal issues relate to CES, mostly due to delayed diagnosis and lack of urgent MRI access.
A national shortage of radiographers means some hospitals can’t provide emergency scans promptly.
Moving Forward: Awareness and Advocacy
Mandy continues to live with the aftermath of CES. She must self-catheterize to empty her bladder, increasing her risk of infections.
Bladder Botox and nerve pain medication help, but the side effects wear her down.
Determined to help others, she hands out information about CES in clinics and hospitals.
Martin, too, is raising awareness after settling a legal claim over the delay that left him disabled.
“If I’d been diagnosed sooner, maybe I’d have avoided these lifelong problems,” he says.
Both Mandy and Martin’s experiences highlight one clear message: never ignore severe back pain that comes with bladder or leg symptoms.
Quick action can save nerves, prevent permanent damage, and change lives for the better.
If you or someone you know starts having difficulty peeing, numbness in the genital area, or weakness in the legs along with back pain, please seek emergency medical help immediately.
Early diagnosis and surgery can make all the difference.