Cauda Equina Syndrome

Cauda Equina Syndrome is a spinal emergency that needs urgent treatment, thankfully it is very rare. Somerset NHS Foundation Trust has referral pathways in place for general practitioners (GP), emergency departments (ED), minor injury units (MIUs), or specialist clinicians in the orthopaedic assessment service in Somerset (OASIS) to use. These pathways aim to identify those patients who need emergency investigation and treatment from those that can safely follow the national pathway.

Our Cauda Equina Syndrome pathway is designed for people who would normally come to Musgrove Park Hospital’s emergency department for their care. If you live closer to Yeovil, Weston General, or Royal United Hospitals you should attend that hospital. These hospitals have their own pathways, but they will be able to complete the same initial assessment and investigations that would be completed at Musgrove Park Hospital. Most people who may have symptoms and signs of Cauda Equina Syndrome thankfully do not when we complete further tests. Therefore, it is best for you to go to your local hospital for the initial assessment and investigations. If that hospital’s team are concerned they can contact their nearest spinal team for advice.


New onset, or a flare up of, back and/or leg pain with any of the following:

  • New or worsening change in bladder function (not knowing you want a wee, having problems starting or maintaining the flow of urine, not fully emptying your bladder)
  • New or worsening change in bowel function (not feeling you are pooing or pooing yourself)
  • New or worsening change in sexual function (not feeling sexual intercourse, not being able to gain or maintain an erection, not reaching orgasm as normal)
  • New or worsening change in saddle sensation (change in feeling around your bottom or genitals, or between your legs)
  • New or worsening severe pain in both your legs.

If you have started getting any of these symptoms, please seek emergency help immediately.

If a medical professional has assessed you and referred you for Emergency investigations, please read the  patient information leaflet for more information.