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

I think you’re doing this the wrong way round OP. Go to A&E first. If you get the all clear from them or better feedback as to the cause, you can go to an osteopath afterwards for some practical relief if necessary/appropriate.

This is not correct, if they are concerned they may admit and then an MRI could be done.

My GP told me they are not allowed to refer for MRIs, has to be done through the consultant/clinic you are referred to.

Yes if they admit her they can but they won't do an mri for anyone just waiting in a&e

….unless they have features suggestive of cauda equina syndrome and then they just might…before deciding to admit/transfer. HTH.

For people asking me why I'm not rushing to A&E, here is the reason ^

My husband is back from work around 11pm. I will see if we can get to A&E then.

Re medical advice, it was 1 young midwife on the phone who was advising on soemthing she freely admitted was outside the remit of what she can advise on/manage. The GP (who was a trainee and had another doctor check everything so 2 GPs) could have referred me to A&E or further tests and they didn't.

not pregnant but i do have a messed up lower back and sciatica. (my l5/s1 is gone)

small tip that might help, do not sit straight up from your bed, you will put more pressure on the disks and sciatic nerve.

lay on your side on the edge of the bed, let your legs drop off the bed and at the same time use that momentum and the help of your arm to lever yourself up sideways.

If its issues weight bearing on one leg, its quite likely its your SI joint on that side, they can get 'stuck' and there isn't much you can do other than wait for it to unstick..

I recently had to start using crutches rather than a walking stick to try and level out my gait as i walk with a limp because of referred pain and joint issues and my SI joints joined the party...

I do know exercises for helping release the SI, but i'm not sure they're safe in pregnancy so won't pass them on.. and the downside if you CAN do them, is they irritate the sciatic nerve... that was a fun week for pain, not. But on the upside, my SI joint 'unstuck' after 4/5 days.

Good luck, i hope it resolves for you.

I get all the people saying go to ED, and yes you should go as advised, but I would absolutely be prepared for them not to do anything. Even if they can identify what’s wrong, it’s unlikely they’ll do anything other than physio whilst you’re pregnant. If the osteopath will see you, then hopefully that helps. I had something similar when pregnant and it was solved by swimming. Wasn’t the same or as constant as what you describe but excruciating pain in certain positions. Something had popped out of place and was put back by the leg motion of breaststroke.

Go to A&E OP.

I had a slipped disc earlier this year, very similar symptoms to you (although I wasn't pregnant). I contacted 111 who arranged for me to have an appointment in A&E (might be something to consider).

I did have a bit of a wait but ultimately ended up with an MRI to rule out cauda equina (I had a weakness in one of my legs and couldn't stand on it). That's how they diagnosed the slipped disc - gave me codeine (60mg 4x day for the first 3 days, then dropped to 30mg 4 x day) and I eventually left 14 hours after I'd arrived.

The pain is the worst I have ever had - worse than either toothache, neuralgia, childbirth, or migraine.

i think pain relief is more important than a diagnosis and an mri

the problem is with sciatica that the type of pain relief required for nerve pain is limited, and has some nasty side effects.

Most pain relief won't work and if anti-inflammatories WILL help, they're often not recommended in pregnancy.

I take gabapentin and naproxen to keep mine ay bay, and some days it still doesn't touch it.. hence me using crutches/wheelchair at 43.

does the osteo specialise in pregnancy?

Have you been to this one before?

That's not true. I've had two MRIs for back pain via A and E

This info may be helpful in deciding whether to go to A&E or not.

www.plymouthhospitals.nhs.uk/display-pil/pil-back-pain-6069/

depends on the area, they won't where i am unless its an absolute emergency, i had to wait 18mo and go through the MSK team for mine.

I'm not a doctor or a physio, but I have had a bulging disc which gave me similar pain and immobility. What helped me was a TENS machine and hot baths (not at the same time, obvs) and kneeling on the floor curled up into a foetal position. Various drugs prescribed didn't even touch the pain.

Good luck, OP

Don't take my word for it, but I had read that ibuprofen is only a problem during the first and third trimesters. Which might be why you were told to take it.

So you've been told what to do. Go to A and E.

Your midwives have said got to A&E. Not at 11, now. Get a taxi.

I didn't realise dihydrocodeine was a drug one could take in pregnancy, every day is a school day. I hope you get the medical help you need ASAP.

Don't try to sit as it's the worst thing if it is a disc issue
If you lie on your side put pillows between your knees and try not to bend or twist. Keep moving very gently so you don't get stuck
Painkillers regularly
Someone up thread has described how to get out of bed, there's videos if you google log roll in/out of bed

If you do get ANY changes to your bladder or bowels then don't wait to go to a&e. My only symptom was a feeling of warm water running down my legs

It's probably not reassuring but I had a totally numb leg I was having to drag behind me and it wasn't cauda equina at that point, just a very herniated L5/S1

It must be different for different trusts ours you have to be admitted for and they don't do them through the night. Ours only do xray and ct 24 hrs

I’ve also had MRI through A&E in the last month, with symptoms almost identical to OP’s (minus the pregnant bit!)

The MRI did not show anything, but the back pain was so intense I honestly thought my spine was disintegrating. Any lower back pain is just bloody horrible.

i have to say, as someone with severe long term chronic back pain that is VERY specific to having degenerative disk disease, who was fobbed off with that kind of bullshit for 20 years before they'd finally get me an MRI to diagnose, and who is now mobility disabled,.. i loathe advice like this (not blaming you btw, more the page) as its reductive.

NHS needs to take back pain more seriously and diagnose quicker rather than fobbing people off.

I had something similar in my first pregnancy - excruciating pain to the point where I couldn’t walk at times. It lasted on and off for a couple of months and then suddenly stopped. I called an ambulance once and, like others have said, the paramedics weren’t too interested as long as didn’t develop incontinence. Just advised not to worry and to take appropriate pain medication. It did go away in the end! I thought it was maybe just baby pushing on a nerve somewhere. Hope you feel better soon 🤞