A&e, doctors or wait it out?

[autienotnoughty]

Off and on back pain for past 15 years. More on in past two years. Symptoms include lower back pain, painful spasms , shooting pains in thighs. Being managed with physio, Pilates, walking and yoga.

Last six weeks pain has got significantly worse. I keep experiencing weakness in my legs, periods of not being able to stand/needing support to walk and get up.

Today my back has locked three times leaving me unable to walk, getting worse each time. I am now laid flat on my back, I can't sit up. Dh had to drag/walk me to the toilet. I can't walk. I can't turn over. I'm applying heat and cold.
I'm also feverish . I have shooting pains/tingling in my legs plus the back pain and spasms.

Do I go a&e?
Ring doctor Monday?
Ride it out?

No, this lady has had 'back issues' for 15 years. She has had this acute problem, which can't be ruled out as extremely serious, for a short period of time. It really irritates me when people chant out 'A&E is for accidents and emergencies' when they have no idea what small details turn a situation into an emergency.

@autienotnoughty if you found it difficult to urinate, I would want to at least speak to 111. Can you feel your inner thighs and genitals? Do you have any numbness or tingling in that area?

Just my experience and another guy in A &E with me. Now I remember there was another guy too and his wife wheeled him in.
They left us all sitting there
Id had it for years as well, just like OP.

Ultimately it’s up to OP what she does but she will need to be prepared to wait
( unless her local A & E are lucky not to have to deal with too many life and death emergencies )

Usually I am very much a wait and see kind of person but you don't fuck around with cauda equine symptoms. Off to the hospital with you!

Wishing you a quick wait x

I’ve been told in the past ( by dr) that is a definite sign to get immediate medical help.
List your symptoms exactly as @everybodystalking suggests.
Good luck.

Call an ambulance right away. It might not even be related to your 15yr back problems.

Pain management is an A And E type of job

You have 2 out of 3 'red flags' to your back pain - change of sensation (the tingling) and difficulty going to the toilet. The third is change of sensation when you wipe yourself after going to the toilet? As much as you probably don't want to be sat in A&E you definitely need to be properly examined in the least to rule out something called cauda equina with potential scans depending on their examination findings.

My daughter has just spent nearly three weeks in hospital with the same symptoms.

she had an infection in her spine and was on antibiotics the whole time

Just to say when this happened to me it was during surgery hours and they advised me to go to A&E. I did try the surgery first. So I wouldn't say this is misuse of A&E.

You have some red flags for cauda equina. You need A&E. At least call 111. Please mention the toilet difficulty.

I think the risk of not doing anything and it ends up being cauda equina outweighs the potentially long wait.

If OP can feel the genitals and area around the anus and pass urine then it will not be treated as causa equina.
She’ll lie in ED on a trolley , get some pain relief and be home in 24-48 hours. Think about these symptoms carefully OP. If passing urine is difficult then yes get yourself to hospital .

I have slipped discs which frequently flare-up - the symptoms that the OP is describing are exactly the ones the consultant has told me to go to A&E for. This could very well be an emergency.

I had no issues with any of the above and I walked into a&e
It was still cauda equina and I said I thought it was to triage. Scanned and confirmed

Not true. Which is why giving unqualified medical advice is dangerous. My friend has had back pain for years. Suddenly got worse on holiday. She could barely get on the plane. Went straight to A&E on landing, and was treated as high priority due to cauda equina, which has the risk of paralysis if not treated urgently. She was admitted from A&E and operated on the following day. Don’t give medical advice if you don’t know what you’re talking about.

A&e they need to test for cauda equina

OP if you are unsure call 111 - they can tell you if you need A&E

If they say go to A&E try and make sure you have some things with you to make the wait more comfortable.

Cauda equina IS an emergency! Jeez.

Do you have a fever? A fever (as in high temperature not just feeling hot) can be an A&E issue especially if its not coming down with paracetamol.

The rest will not be dealt with at A&E as its not an Accident or Emergency and I say that as someone with skeletal issues that has back problems aswell and have personally learned this. A&E only deal with it if you have had a high risk accident (long fall, car crash, horse tredding etc...) or if you have loss of bowel/bladder control. Sitting in A&E in pain, being ignored and then sent home won't help and if your anything like me it will be hard physically getting there.

Back pain does suck and if its too much to wait till Monday to be seen then call 111 and ask for an emergency care center walk in appointment. They will see you much faster, prescribe medications and possibly send you straight for tests (like scans or xray's) if needed.

I've had asthma for 30 years. If I had an asthma attack would that not be an emergency?

Cauda equina is an emergency.
So get off your soapbox.

Anyone showing symptoms of symptoms of cauda equina will ALWAYS be sent straight to a&e. Unless you receive urgent surgical intervention, it causes permanent paralysis.

Hopefully op just has a particularly bad case of sciatica, but she won’t know until she’s seen

Apparently not no. You’re just expected to manage the symptoms and then die. The you can try and phone the GP the next working day, post mortem

Please go to a&e, I had a very similar situation and ended up calling an ambulance as I completely lost power in my legs, had an mri almost on arrival, where it was discovered I had cauda equina, emergency surgery that night. Very much an emergency so please do get help.

I’d call an ambulance. My father had a similar background to you - years of back
issues. Then one day he couldn’t get up and initially thought it was an extension of that. And well, I won’t scare you with what it was, because this probably isn’t that, but you need to go to to the hospital and get checked out ASAP.

Firstly, so sorry for your pain. It takes other sufferers to understand the agony.
You definitely need to get checked for cauda equina.
As it’s Saturday night you will clearly have a long wait, but it is necessary due to the possibility of an incredibly serious condition.
If this condition is ruled out, you will probably be sent home with advice about painkillers.
When I was in a similar situation to you in the summer, I was sent home without any further tests.
A subsequent MRI revealed a fracture at L3, bulging disc causing nerve pain & arthritis of sacral joints.
I do hope cauda equina is excluded & you get a diagnosis. Update us!

exactly the same as me - always had back issues but had a period when it felt very unstable and I was suddenly unable to put weight through my legs and thought I’d pass out from the pain. I went to A&E and had a bulging disc but nothing more “serious” so to speak. Not minimising your situation and do what you think is best - but honestly I thought something much worse was going on that they’d find immediately.