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

Don't lie to doctors

Go to the maternity assessment unit, not a&e

I’d go straight to A&E now. Don’t wait for your husband - that’s wasting three hours when she could be getting seen

I have sciatica (I know what you have is more than that) and I find hot water bottles, voltarol and hot baths help a lot. I literally rub voltarol everywhere. I'm not sure if it's ok if you are having a baby though.

Yep, I was surprised how effective these hot and cold gels were last time I was in agony with my back

Your description reminds me of how I was when pregnant with my second. The pain was unbearable, I had SPD, unfortunately all I was offered was pain killers some physio and told it would go after birth, which it did. I really do sympathise, get all the help you can from family members to help with your other children, I remember crying crawling on my hands and knees trying to get my 2 year olds PJs on, I had no one to help and hubby worked long hours.

if you think it’s something other than back pain that is muscle related, have any other symptoms I would go to A&E.

Wtf is wrong with the healthcare system when pregnant women are being told to avoid A&E ‘cause A&Es are busy’. OP’s symptoms need to be assessed. They may be due to sciatica or another non- life threatening issue but in pregnancy things can go downhill very quickly.. Why on earth would anyone rely on the reassurance of strangers online who have no medical background / let alone haven’t examined you

There's no way she'll be seen within 3 hours, unless she's having a heart attack. She's likely to be there all night, on a plastic chair and then, if she's admitted, a trolley in the corridor. These responses would have been correct 5-10 years ago, when A & E was a place you could go to get help. It's not like that now. They'll save your life if you're dying, that's about it.

I’m currently 7 months pregnant and at around 5 months also experienced very bad pain in my lower back and SI joint..I’ve been seeing an Osteopath once a month and it’s really helping. When you are pregnant the body produces relaxin to relax the joints for birth but this can lead to some joints going a bit out of kilter..an osteopath will be able to manipulate you and you should feel a whole lot better hopefully. I hope you feel better soon!

Sounds like very similar symptoms I had when I had a ruptured disc. Do push for an MRI, although there is depressingly little which can be done in the immediate.

If you can afford it see a private spinal surgeon and request mri

Oh OP my back did this to me earlier in the year whilst we were on holiday & it's the only pain I've ever experienced that's reduced me to tears (I've huge tattoos, 3 births, multiple gallstone attacks, cracked tooth up into my sinus & years of sporadic of herniated disc pain).

The ONLY thing that helped me to any degree was a TENS machine, with the pads either side of my spine slightly offset to the side the bulge was happening. HOWEVER you're pregnant so I'm not sure on how to use TENS safely without inducing labour by accident.

Walking was manageable but sitting, laying, sitting on the loo was absolutely not. Also try laying on your side with a cushion or pillow between your knees so your hip & leg are horizontal & not tilted at all.

My back resolved itself after about two weeks with one week of that insane pain, just fucking wild pain - even dh putting the tens pads on me made me cry.

GP said if it happens again the only reason to go A&E is if you cannot wee/poo (cauda equina) cos that's an emergency. He also said...I'll whisper... (you can lie & tell them you can't wee or poo & they'll have to mri you. But surgical solutions aren't necessarily the answer anyway so probably not worth it).

Can you share your source for that advice? Think we’re all still taking the MHRA 2023 advice as being most up to date but it’d be great to know if that’s changed.

(I used the word ‘generally’ because occasionally NSAIDS are used for short periods in 2nd trim but, as per the MHRA advice, that needs to be with medical input, bearing in mind any particular details of the pregnancy, and with consideration of more monitoring of the fetus because of the risk of renal impairment and narrowing of the ductus. NSAIDs should absolutely be avoided in 3rd trim. It would seem rather bold to advise the OP to just crack on with ibuprofen on the basis of not much information and without advising her of the possible pitfalls!)

Go to your maternity assessment unit. You will be seen very quickly.
GPs are not trained fully to understand your needs as a preg lady and A&E is going to be a real painful experience waiting in there. Both useless.

Have you tried those stick on heat packs? I find heat more effective than pain killers for back pains.

Please go to A&E asap.

SPD was the first thing that occurred to me as well, and an osteopath is definitely a good option to help.

I got mine very late in pregnancy and after I'd had my son I could hardly get up the stairs, and wondered how the heck I was supposed to look after a baby if I couldn't even get up the stairs. She worked miracles - I only needed to go twice.

But if you were told to go to A&E, go to A&E. And your partner should have come home early to take you, unless he's a surgeon himself!

It sounds like you could have a compressed nerve. I’d brave a&e to get an MRI if I were you. As painful as it is, try to keep gently moving and keep mobile. The movement will help. Good luck and hope it eases 💐

I often wonder about this type of totally unsympathetic replies???
Why?.....

Also another one for osteopathy and physio/pilates. I had osteopath treatment for PSP for both pregnancies and it helped keep my chronic back pain at bay too. The numbness and heavy legs are 🚩 that shouldn’t be ignored! Hope it gets better for you!

There was another pregnant mum when I was in hospital with SPD I'd never heard of it before, it sounded horrendous.

Add in @Aandespine previous sciatica issues the pain must be off the chart.

Sorry to hear about your pain. Please read this link.

https://patient.info/bones-joints-muscles/back-and-spine-pain/cauda-equina-syndrome#symptoms-of-cauda-equina-syndrome

Scroll down to symptoms. If you have any of these you must go to A&E. If you have relentless severe pain you should also go for pain relief.

If you don’t have either of those then going won’t be helpful.

You will wait for hours and hours. Get seen. Get examined. If you report any of the symptoms on that link you will get a bladder scan after you’ve emptied your bladder and also a rectal exam to assess your anal tone.

If these things show concerning signs in conjunction with your other symptoms then you will then have to wait for an MRI. In some cases you will get admitted and wait for it the next day as smaller hospitals don’t do MRIs out of hours. If they were really worried they could transfer you elsewhere but that is rare.

If you don’t have any of those symptoms then they won’t be doing an MRI as it is not indicated for acute sciatica or back pain. They will try get your pain better controlled and ask you to follow up with you GP.

There’s a lot of bad advice in this friends so be careful.

Sounds like the SPD I had was fine one day next day woke up and I couldn’t get comfy sitting or standing I was crying rocking hunched over a chair. Needed a support belt and physio. It eased once baby arrived but it was agony

I wouldn't place my hopes on an MRI any time time soon. Been waiting for an 'urgent' MRI brain for my 1 year old for over 6 weeks. I don't think you will get anything out of going to A&E to be honest. Ring maternity for advice.

Hi op, this basically happened to me at 17 weeks pregnant, I have a herniated disc and get sciatica anyways but this was next level pain like you've said. It was a rush of relaxin that made my back go, by 24 weeks I was so much better ! I do agree A&E will only prescribe pain relief and very doubtful they'd xray, I would use a hot water bottle and take the painkillers