When a slipped disc happens, it can cause pain and numbness. When Cauda Equina Syndrome happens, it is a medical emergency as serious as a stroke or a heart attack.
Cauda Equina Syndrome is like sciatica or a slipped disc on steroids. Herniated discs can cause back pain, numbness in the legs and feet, or even cause periods of erectile dysfunction or bladder and bowel dysfunction. When Cauda Equina Syndrome happens, all of that becomes permanent and more. It is sometimes preventable when a Veteran shows up to a hospital with any of these symptoms, but the VA or ER doctors can miss the diagnosis.
If rapid surgery isn’t done within 48 hours, a mistaken diagnosis can become a life-long disability.
If you feel like your Cauda Equina Syndrome could have been prevented by the VA because of a misdiagnosis, let’s talk about your medical records and see if we can get you the disability compensation you deserve.
In this article about Cauda Equina Syndrome VA ratings:
- What Causes Cauda Equina Syndrome in Veterans?
- Lumbar Disc Herniation Can Cause Cauda Equina Syndrome
- Spinal Stenosis can Cause Cauda Equina Syndrome Over Time
- Why Cauda Equina Syndrome is an Emergency Version of Sciatica
- Ankylosing Spondylitis and CES
- The Red Flag Symptoms of Cauda Equina Syndrome
- How to Cauda Equina Syndrome is Service Connected
- Various Cancers Can Cause Cauda Equina Syndrome
- Sexual Problems Caused by CES
- Is it Invertebral Disc Syndrome or Cauda Equina Syndrome?
What Causes Cauda Equina Syndrome in Veterans?
This is a rare back and spinal disability that is caused by damage to a specific section of your lower back. When pressure is put on the Cauda Equina section of nerves, many of the symptoms of a herniated disc happen. If surgery is done on the vertebrae before permanent damage is done, many of the symptoms can be reversed.
Lumbar Disc Herniation Can Cause Cauda Equina Syndrome
Lumbar disc herniation is the most common cause of CES. It can be brought on by compression, trauma, or even bad posture. Carrying 110 pounds of the world’s lightest kit can wear down your back over time, so Veterans’ backs are susceptible to injury. If you have a herniated disc or a bulging disc in the lumbar region of your back, you can live with those conditions for years.
CES becomes an issue when your periodic pain, numbness, or tingling from your herniated disc suddenly becomes worse. You might bend over or pick something up to trigger that pinched nerve. If all of the symptoms below show up, you might be in the middle of the onset of Cauda Equina Syndrome. That means that a nerve that once just had pressure is about to be severed or permanently crushed.
Spinal Stenosis can Cause Cauda Equina Syndrome Over Time
Spinal stenosis is most often a frozen up spine. You can’t twist and turn or you can’t bend over with your back if you have spinal stenosis. You may already have VA disability for spinal stenosis. If you have already been diagnosed with spinal stenosis, it’s good to know about the symptoms of Cauda Equina Syndrome before it happens to you. It probably won’t, but if it does, you want to know about it.
A frozen spine can put a lot more pressure on the other vertebrae so that nerves get pinched. If your Cauda Equina vertebrae get pushed out of place because of spinal stenosis in other vertebrae, you’ll want to seek medical attention immediately.
Why Cauda Equina Syndrome is an Emergency Version of Sciatica
Sciatica or slipped discs cause pain or numbness to travel throughout the nervous system. If nerves from the spine to your feet are affected, you’ll have neuropathy or sensory loss in your feet. If it’s caused by Cauda Equina Syndrome, that tingling will lead to paralysis or long-term bladder and bowel issues. 40% of patients with Cauda Equina Syndrome that lose bladder or bowel control gain it back within 2 years of when it starts.
A herniated disc is like radio interference but Cauda Equina is like radio silence for your nervous system.
Ankylosing Spondylitis and CES
This form of arthritis is a pain in the back but can eventually lead to bones in your back fusing together. That uncontrolled fusion can lead to your disks slipping and natural support failing. If that happens to your L4-5 or L5-S1 discs in the lumbar spine, you are ripe for CES. If your daily back pain or incontinence suddenly increased, seek medical attention fast and request an MRI to check for Cauda Equina Syndrome.
The Red Flag Symptoms of Cauda Equina Syndrome
Remember, this is like a stroke or a heart attack. You may have any of these symptoms on a typical day, but when they all come together, you want to seek medical attention quickly. You may have frequent urinary tract infections or bowel dysfunction from other injuries, but when most of this list overlaps, you want to get an MRI for CES.
- Bowel dysfunction (Can occur as diarrhea or constipation)
- Urinary Incontinence (You might pee when you don’t want to or can’t when you want to.)
- Sexual dysfunction (Erectile dysfunction in men or extreme pain in women.)
- Disturbed gait (Unsteady steps, like one foot or leg can’t keep up with the other.)
- Saddle anesthesia (Numbness of the whole area of your groin that would touch a horse’s saddle.)
- Paraplegia (In severe or delayed cases, complete paralysis from the waist down.)
Cauda Equina nerves control genitals, anal sphincter, bladder muscles, and legs and feet, ankles, knee reflexes, and the skin surfaces from the knee down. You can see why it is urgent to avoid permanent damage to these nerves. It needs to be diagnosed with an MRI or CT scan. If it’s discovered, it has to be treated by surgery within 48 hours. Failure to act fast can make any or all of the symptoms permanent.
One of our VA Disability Lawyers gives tips on how to properly prepare for your C&P Exam.
How to Cauda Equina Syndrome is Service Connected
Trauma to the spine from a car wreck, impact, gunshot, explosion from an IED, or another injury can bring it about instantly. If you have evidence of one of those kinds of injuries, you’ll have an easier job of service-connecting your disability. At that time it was most likely an immediate surgical emergency and there are records of it in your C-File.
You might not have a direct injury like that, but you might have been in a car wreck, sports injury, or parachute fall while you were in active duty. If you have a football injury while on leave, that still counts as an injury during active duty. One veteran, 10 years after a car wreck during active duty, was awarded a rating for Cauda Equina Syndrome. The back injury he sustained during active duty progressed over the course of 10 years of civilian life and lead to CES. He was awarded a rating based on the loss of bowel and bladder control, even though none of those symptoms presented themselves while he was enlisted.
Various Cancers Can Cause Cauda Equina Syndrome
If you were in Vietnam, there are presumptive conditions that you may qualify for just for being in the right place at the right time. Some of those involve cancers like myeloma that create tumors and obstruct bones and nerves. If they develop in the spinal canal, they can pinch or disrupt nerves and eventually bring about Cauda Equina Syndrome.
Surgery to remove those tumors can also result in Cauda Equina Syndrome as the surgical procedure interferes with the nerves of those vertebrae. Back surgery while in the service might not lead to CES for 15 years. Once it sets in, you may be able to show through X-Rays and medical evidence that your current back problem is related to the surgery you had when you were 26 in the service. You always want a doctor familiar with VA Disability Law to look over your application. That is why we have doctors on staff at our law firm to have eyes of experience on your application.
Bladder and Bowel Disabilities Affected by CES
Cauda Equina Syndrome can affect your bowels. Many times constipation can be unrelated, or regarded as unrelated because pain killers or other medications that people take for the other symptoms can cause constipation. The same goes for diarrhea.
CES affects the way your muscles work so that instead of moving feces through your bowels correctly, they either move through too fast or too slow. The anal sphincter muscles can also be affected so that they open too easily or they cramp shut. Even if your bowels were working right, a disabled anal sphincter is going to be trouble.
Bowel and bladder functions are affected by a whole orchestra of nerves and muscles. Your doctor might mention micturition. Micturition is a big word for going pee. There are several muscles and dozens of nerves that work together to control the pressure in your bladder, the opening and closing of your internal urethral sphincter, and the valves that prevent the backflow of urine into your kidneys. Cauda Equina Syndrome can disrupt any part of this process.
If you were previously seeking a VA Disability Rating for urinary incontinence or bowel incontinence, you might want to talk to your lawyer about getting a rating for more. If you have had mild CES for a long time, you might be entitled to a higher disability rating.
Sexual Problems Caused by CES
Since Cauda Equina nerves affect the whole groin area, what the VA calls your “creative organ” can also be disabled. Muscles and nerves work together to form an erection or to relax the cervix and vagina during sex. The result is either erectile dysfunction or painful sex. The VA does give a rating for “Loss of use of a creative organ” that you may qualify for.
Depending on the diagnosis of Cauda Equina or another diagnosis, this is a disability that carries its own rating. The VA is always supposed to side on the behalf of the Veteran so that they will always receive the highest rating available. If the erectile dysfunction is rated higher than the nerve damage or back injury, the VA will award that rating. If loss of use of a creative organ isn’t as high as the back injury that caused it, they may go with the back injury.
Depending on the diagnosis, you might be able to get one rated as a service-connected disability and the other rated as a secondary service-connected disability. In that case, you’ll have to use the combined rating table to figure out what they add up to.
Is it Invertebral Disc Syndrome or Cauda Equina Syndrome?
Intervertebral Disc Syndrome is the condition where you actually have broken off parts of bone or other tissues in the wrong places in your spine. This is similar to the compression of Cauda Equina Syndrome but can occur in many more places. IDS can occur in any of your vertebrae, while CES is only in your lower tailbone area.
An MRI can detect the difference, but sometimes it’s hard to get a doctor to call for a full MRI when you are just suffering from a few symptoms. Be clear with your doctor about what symptoms you are feeling, how severe they are, and at what speed they are coming on. The speed of the onset is a key indicator of what makes CES different from other back problems.
Death is not likely, but if left untreated, CES can result in permanent paralysis from the waist down. While the symptoms come on quickly, sudden death is not common with Cauda Equina Syndrome.
Cauda Equina Syndrome is a medical emergency and the cluster of symptoms come upon you or increase in severity relatively quickly. Chronic back pain isn’t a sign of CES, but sudden bladder and bowel dysfunction, an uneven gait, neuropathy in your feet and legs, and pain in your skin can all point to CES. Only an MRI can fully diagnose it.
Yes, that is a common claim that earns VA benefits. Since Cauda Equina Syndrome is often misdiagnosed, you may be entitled to extra VA Disability Benefits if an MRI scan later proves that you have it and nobody knew it.