Jacky is 57 years of age. Her GP referred her to physiotherapy for low back and leg pain and she completed a PhysioNow® assessment the same day. Following an assessment of her symptoms the outcome advised her to contact Urgent NHS 111.
The Connect Health clinician called the patient on 7 October to check her symptoms.
- Jacky reported that her symptoms had started 2 weeks previously with back and leg pain after decorating and lifting her grandson.
- She had previously had breast cancer in 2012 and 2018 and did report weight loss of 2 stone but she had been intentionally dieting.
- Jacky confirmed she was experiencing numbness around her genitals and bottom and also had some difficulty emptying her bowels, however this was getting less frequent. These symptoms are potential indicators of a rare but serious condition called cauda equina syndrome where the nerves at the bottom of the spine which control bladder/bowel function can be compressed
- The clinician arranged an urgent lumbar MRI.
- 7 days later Jacky was imaged and this showed spinal metastases (these are secondary malignant growths, in this case related to her previous breast cancer) and her care was handed over by a triage clinician to her GP.
Jacky was sadly diagnosed with spinal metastases 12 days after she accessed PhysioNow. In a standard physiotherapy pathway, she may not have had a consultation within that timeframe. At the time of speaking to the clinician she had no symptoms that met NHS England’s guidance on urgent or emergency presentation of suspected spinal metastases symptoms, so community imaging had been an appropriate pathway for her.
Download Jacky’s full story here