If there is clinical suspicion of Cauda Equina Syndrome, please see the Cauda Equina Syndrome section of this page.
If there is progressive foot drop with associated leg pain over the course of days, please refer urgently to the on-call team via Refer a Patient, as there may be a role for early surgical intervention. If the patient presents with painless foot drop, please discuss the case with neurology.
Please note that a disc herniation in the cervical spine will cause symptoms of cervical myelopathy or radiculopathy - please refer to those sections. In the thoracic spine, it will cause similar symptoms but spare the upper limbs.
For all other cases, where there is no sudden significant neurological decline, please refer via the services Musculoskeletal Interface (MSKI) Service.
Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.