What to do if…
you develop new weakness in both legs or worsening trouble walking over a few hours
Short answer
Treat this as an emergency. Call 999 now and say you have sudden or rapidly worsening weakness in both legs / trouble walking that has worsened over hours (and mention immediately if you have any breathing or swallowing difficulty).
Do not do these things
- Do not drive yourself to A&E or try to “push through” and walk it off.
- Do not take a bath/shower or use stairs while your legs are unreliable (falls risk).
- Do not repeatedly “test it” by standing/walking if you feel unsafe or it’s getting worse.
- Do not ignore new bladder/bowel changes (even “just once”) or numbness around your genitals/bottom.
- If swallowing feels unsafe or your speech is slurred, do not eat or drink while you wait for help.
What to do now
- Call 999 for an ambulance.
- Use speakerphone if you can.
- Say: “New weakness in both legs / worsening trouble walking over a few hours.”
- Make yourself safer while help is on the way.
- Sit or lie down somewhere stable (bed/sofa/floor).
- Keep a phone within reach. If you live alone, unlock the door if safe to do so.
- Tell 999 right away if any of these are present (they change urgency and response):
- Bladder/bowel changes (can’t pass urine, new leakage, loss of bowel control).
- “Saddle” numbness/tingling (between the legs, around genitals, or around the anus/bottom).
- Severe back pain, recent injury/fall, fever, or rapidly spreading weakness/numbness.
- Stroke signs (FAST): face droop, arm weakness, speech problems — or sudden trouble walking/balance issues.
- Breathing or swallowing problems.
- Write down a quick timeline (or text it to someone).
- When it started, when it clearly worsened, and what changed.
- This helps clinicians make time-critical decisions.
- Gather essentials for the ambulance/A&E (one small pile/bag):
- Medication list (or the packets), allergies, key conditions, and photo ID if you have it.
- If you take blood thinners or recently changed medication, make that easy to tell them.
- If you can, ask someone nearby to stay with you until the ambulance arrives.
- Their job is practical: prevent falls, relay the timeline, and bring your meds/ID.
What can wait
- You do not need to figure out the cause right now.
- You do not need to search symptoms or decide which condition it “sounds like.”
- You do not need to pack much—focus on being safe and getting assessed quickly.
Important reassurance
It’s normal to feel alarmed and uncertain when walking suddenly becomes difficult. Getting urgent assessment is the safest choice here because some causes are treatable but time-sensitive, and delaying can increase the chance of lasting problems.
Scope note
This is first-steps-only guidance for the next few hours. After you’re assessed, clinicians may advise scans, blood tests, and/or specialist review depending on your symptoms and examination.
Important note
This guide is general information, not a diagnosis. New or rapidly worsening weakness in both legs or worsening walking over hours should be treated as an emergency—especially with bladder/bowel changes, saddle-area numbness, severe back pain, or stroke-type symptoms.
Additional Resources
- https://www.nhs.uk/symptoms/paralysis/
- https://www.nhs.uk/conditions/stroke/symptoms/
- https://www.torbayandsouthdevon.nhs.uk/services/specialist-spinal-orthopaedic-physiotherapy-service/common-spinal-conditions/cauda-equina-syndrome/
- https://www.buckshealthcare.nhs.uk/pifs/cauda-equina-syndrome/
- https://gettingitrightfirsttime.co.uk/wp-content/uploads/2026/02/National-Suspected-Cauda-Equina-Pathway-February-2026.pdf