Red Whale Primary Care Pod Something we never want to miss, and something we might have missed... cauda equina syndrome, and the new NICE guidance on menopause- any changes to our practice?
Feb 21, 2025
The discussion dives deep into the complexities of spinal cord compression and cauda equina syndrome, emphasizing the need for keen recognition of red flags in low back pain patients. It highlights new NICE guidance on menopause, revealing practical insights that may shift clinical practices. Personal anecdotes about engaging with podcasts add a relatable touch, while the importance of tailored care and risk communication in hormone replacement therapy is brought to light, especially for women with genitourinary symptoms.
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Early Recognition of Spinal Emergencies
- Remember spinal cord compression and cauda equina syndrome must be treated as emergencies needing same day referral.
- Recognize early signs like altered saddle sensation and urinary difficulties to prevent serious outcomes.
Motor Neurone Sign Differences
- Spinal cord compression causes upper motor neurone signs; cauda equina syndrome causes lower motor neurone signs.
- Upper motor neurone signs are 'things going up' like increased tone and reflexes; lower motor neurone signs 'go down' with reduced tone and reflexes.
Back Pain Red Flags Guidance
- Be aware of varying red flags for back pain; use guidelines from BMJ 2013 and National Suspected Cauda Equina Pathway 2023.
- Prioritize history of cancer, infection risk, fracture, and bilateral sciatica as important red flags in assessment.