Should I go to A&E?

[Aandespine]

I'm 5mo pregnant. Woke up yesterday morning with excruciating back pain. I cannot walk unaided (thankfully have a pair of crutches at home I've been using to shuffle to the bathroom and back), cannot sit, even on the toilet seat I'm having to lean to one side, cannot bend over. I'm struggling to lift myself up from the toilet seat, cannot turn over in bed. I'm climbing the stairs on all fours then I take a while at the top (in a lot of pain) to stand up straight again. My lower back is numb and I'm getting tingling pain under my belly, and shooting pains down one leg. One leg feels heavy and weak.

Have been to see the GP. They can't tell me what the issue is, no advice re recovery time or prognosis. They've just prescribed dihydrocodiene. No other advice besides to go to A&E if I experience incontinence or numbness down below. I pleaded with them for an MRI which they say they'll try to request without any guarantees/it will be at the discretion of the radiographer who will decide if there's an indication for it.

Now I've had sciatica in the past and the pain was in no way near this. I'm in tears numerous times a day and the pain is literally exhausting me. I dred going to the toilet. I'm bed bound. I have a family member taking care of my 2 young children.

I haven't yet been to A&E because I cannot sit and wait there for hours to be told the same thing (pain meds and no further diagnostics).

Please tell me what to do

Sciatica down both legs and incontinence could suggest cauda equina syndrome and would indicate further investigation. I attach advice from the NHS website below.

If that incontinence has come on suddenly it needs to be investigated. Pain down both legs does happen with sciatica, but sudden incontinence is the bigger red flag that something more serious is going on.

What a revolting attitude from your GP, just abhorrent!

But, and don't panic, I'd say you do qualify for A&E right now if the incontinence has just come on - that's the red flag bit. Big girl (incontinence) pants on & off to A&E with you (in my non medical but highly experienced fucked-back opinion)

@Aandespine I am so pleased that you were sorted out at A&E and that you know what the problem is.

I disagree about the funding being the reason . The referral quota you mention are for elective referrals not unscheduled emergency ones.

NHS payouts for missed cauda equine syndrome are extortionate. All drs will/should have read about missed cases in their medical insurance journals and therefore know about red flag symptoms

Had the first GP recognised your red flags then he should have referred urgently to orthopaedic team on call. It concerns me that he did not pick up on the bilateral symptoms or examine you.

I am relieved that the A&E dr was very thorough, recognised the red flag and examined you well.

So what is the outcome? What did the MRI help with? Did they give you different painkillers?

maternity physio, different painkillers, the op did update just a bit further back

So hopefully you cancelled the osteo

I think OP had already seen the osteo, before the visit to A&E.

no went to a&e before the osteo app

You poor thing, it sounds horrible. I hope you do see a doctor who will do something to help

She saw the osteo first.

I ended up visiting the osteopath first yesterday, and it was he who suggested that pain down both legs was a sign of cauda equina and that I should have an MRI.

an i missed that thanks

Of course I have but quotas you are discussing are for what they term limited clinical value elective surgeries; which weirdly includes joint replacements though no idea why a joint replacement has limited clinical value when they patients I see are in agony but there you go.

Quotas and commissioning are however nothing to do with emergency work. And I am not the naive one in thinking that a Dr is not going to refer for something they think a patient actually needs due to any commissioning-at the very least due to the now overwhelming legal challenges that Drs face. With us travelling the route of the US, the number of patients jumping to suing because they don’t get what they think they should, is rising hugely and most Drs worry about that all of the time. It’s more idealistic to not be thinking that Drs are concerned about covering themselves so do refer more often than not.

Also, on this very thread, we’ve had a “physio here-lie about your symptoms to get what you want” suggestion. That is a very dangerous route and one I’m sure people do, which is why A&E gets so bogged down with patients who shouldn’t be there and services they don’t need.

My husband went to a physio once. He worked with all the local sports teams. My man had a shoulder injury. Physiotherapist wouldn't touch him but wrote a letter to the GP recommending a scan and sent him off to the hospital . He did get a scan was discovered to be a torn rotor cuff.

Then why, oh why, are you wasting time asking a bunch of strangers that have no knowledge of you or your medical history, what you should do!!??

The thread has moved on since then. The midwife did not take my name or details, did not access my medical records, and only advised A&E "if the pain is really bad" because maternity triage would be limited in what they could do for me.

@HiEarthlings Then why, oh why, are you not bothering to read the whole thread before posting?