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Cauda Equina Claims

England & WalesLast reviewed 18 September 2026

Cauda equina syndrome is a spinal emergency: compression of the nerves at the base of the spine that needs urgent scanning and surgery. A claim arises where a failure to recognise red-flag symptoms and act promptly caused permanent loss of bladder, bowel, sexual or leg function.

Why Timing Matters

Direct Answer: The outcome of cauda equina syndrome depends heavily on how quickly the pressure on the nerves is relieved, so failing to arrange urgent imaging and surgery when red-flag symptoms are present can be negligent.

Typical failings include sending a patient with red-flag symptoms home as having ordinary back pain, not examining for saddle sensation or checking bladder function, not arranging an emergency MRI, or delays in transferring to a spinal centre. Claims often turn on hours and on how the symptoms were recorded, so the medical records, ambulance notes and triage records matter.

Proving Causation

The key question is what difference earlier surgery would have made. Spinal surgeons and neuro-urologists give evidence on the likely outcome had decompression happened earlier, and on the person's current bladder, bowel, sexual and mobility function. Outcomes often differ sharply between patients operated on before and after loss of bladder control.

Compensation

Claims can include damages for pain, loss of function and psychological harm, the cost of care, continence and mobility aids, adapted housing, and loss of earnings. Where future losses are large they are adjusted using the Personal Injury Discount Rate, currently +0.5%.

Frequently Asked Questions

What are the symptoms of cauda equina syndrome?

Numbness around the saddle area, new difficulty passing or controlling urine or bowels, severe or spreading pain and weakness in both legs, and sexual dysfunction. These require emergency assessment and, if suspected, an urgent MRI.

Can I claim if my cauda equina was missed?

Potentially, if a reasonable clinician would have recognised the red flags and arranged urgent imaging and surgery, and the delay caused permanent harm that earlier treatment would probably have prevented.

Why is causation difficult in these cases?

Because the outcome depends on when compression became severe and how quickly surgery could have happened. Experts assess your condition at each stage to decide what earlier treatment would have achieved.

What does the compensation cover?

Pain and loss of function, care, continence and mobility equipment, accommodation, lost earnings and psychological effects, with future losses adjusted for the discount rate.

How long do I have to bring a cauda equina claim?

Generally three years from the date of the negligent act or, if later, your date of knowledge: when you first knew the injury was significant and connected to the care you received. The clock works differently for children, who usually have until three years after their 18th birthday, and for people who lack mental capacity. A court has a limited discretion to allow late claims, but you should not rely on it.

Can I bring a clinical negligence claim on a no win no fee basis?

Usually, if a solicitor thinks the claim has reasonable prospects, because legal aid is not generally available for clinical negligence. Expert reports are a large cost, so many claimants also take out after-the-event insurance. Ask your solicitor how disbursements are covered, and how QOCS protects you from the other side's costs if you lose.

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Where this applies: This page covers England and Wales. The rules in Scotland and Northern Ireland are different.

Sources for this page

Every rule stated above is based on the primary sources below. Each link goes to the legislation, court rule or regulator itself so you can check it. Last verified 18 September 2026.

  1. Courts and Legal Services Act 1990, s.58 (conditional fee agreements)

    The provision that makes CFAs lawful and enforceable. CFAs derive from this section, not from LASPO.

  2. Conditional Fee Agreements Order 2013, arts. 4–5 · in force from 1 April 2013

    Art. 4 caps the success fee at 100% of base costs. Art. 5 caps what may be taken from damages in personal injury at 25% of PSLA plus past pecuniary loss, net of CRU, at first instance.

  3. Civil Procedure Rules, Part 44 (incl. rr.44.13–44.17, QOCS)

    Qualified one-way costs shifting and its exceptions. Rule 44.14 was amended with effect from 6 April 2023.

  4. Limitation Act 1980, s.11 (personal injury actions)

    Three years from the date of the accident or the date of knowledge. Property damage such as a damaged vehicle is a separate claim with a longer six-year period under s.2.

  5. Limitation Act 1980, s.14 (date of knowledge)

    The three-year period can run from the 'date of knowledge': when you first knew the injury was significant and attributable to the act or omission alleged to be negligent. Central in delayed-diagnosis cases.

  6. Limitation Act 1980, s.33 (discretionary exclusion of time limit)

    A court can allow a personal injury claim to proceed out of time where it is equitable to do so. It is a discretion, not a right, and should not be relied on.

  7. NICE NG59 — Low back pain and sciatica in over 16s

    Includes red-flag features that should prompt urgent assessment for serious spinal pathology such as cauda equina syndrome.

  8. Gregg v Scott [2005] UKHL 2

    English law does not compensate a 'loss of chance' of a better medical outcome in a personal injury claim. A claimant must show on the balance of probabilities that proper care would have led to a better outcome.

  9. Ministry of Justice — Personal Injury Discount Rate (England and Wales) · in force from 11 January 2025

    The rate is +0.5% from 11 January 2025, replacing the former -0.25% rate.

Who wrote and checked this page

Written and published by
Edward & Amaury Solicitors (Edward & Amaury Ltd, company no. 12195443), regulated by the Solicitors Regulation Authority under no. 800525.
Legal review
Checked for England & Wales by Edward & Amaury Solicitors — Solicitors regulated by the SRA (no. 800525) (verify on the regulator’s register).Review is recorded against the firm. The individual reviewer is not named on this page.
Review dates
Last reviewed 18 September 2026. Next review due 18 March 2027.

Fee rules change. California’s medical malpractice fee limits changed on 1 January 2023, and the QOCS rules in England and Wales changed on 6 April 2023. If you spot something out of date, tell us — we publish corrections.

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Where this applies: This page covers England and Wales. The rules in Scotland and Northern Ireland are different.

Sources for this page

Every rule stated above is based on the primary sources below. Each link goes to the legislation, court rule or regulator itself so you can check it. Last verified 2 August 2026.

  1. Courts and Legal Services Act 1990, s.58 (conditional fee agreements)

    The provision that makes CFAs lawful and enforceable. CFAs derive from this section, not from LASPO.

  2. Conditional Fee Agreements Order 2013, arts. 4–5 · in force from 1 April 2013

    Art. 4 caps the success fee at 100% of base costs. Art. 5 caps what may be taken from damages in personal injury at 25% of PSLA plus past pecuniary loss, net of CRU, at first instance.

  3. Legal Aid, Sentencing and Punishment of Offenders Act 2012, ss.44–46 · in force from 1 April 2013

    Ended recoverability of success fees and ATE premiums from the losing party. Did not create or regulate CFAs.

  4. Civil Procedure Rules, Part 44 (incl. rr.44.13–44.17, QOCS)

    Qualified one-way costs shifting and its exceptions. Rule 44.14 was amended with effect from 6 April 2023.

Who wrote and checked this page

Written and published by
Edward & Amaury Solicitors (Edward & Amaury Ltd, company no. 12195443), regulated by the Solicitors Regulation Authority under no. 800525.
Legal review
This page has not yet been through independent legal review. It is written from the primary sources listed below, which you can check directly.
Review dates
Last reviewed 2 August 2026. Next review due 2 February 2027.

Fee rules change. California’s medical malpractice fee limits changed on 1 January 2023, and the QOCS rules in England and Wales changed on 6 April 2023. If you spot something out of date, tell us — we publish corrections.