Cauda Equina Rehabilitation For Irish Patients.
Inpatient rehabilitation after cauda equina surgery, at a 287-bed Rehabilitation Hospital in Greece. At least 3 hours of therapy a day for walking, bladder, bowel, pain and mood. Reimbursed by the HSE.
No referral or paperwork needed for the first call.
Cauda equina syndrome rehabilitation at Evexia Plus
Evexia Plus is a specialist Rehabilitation Hospital near Thessaloniki, Greece, where people from Ireland come for cauda equina syndrome rehabilitation as inpatients after surgery. A physician in Physical Medicine and Rehabilitation leads your programme. Physiotherapists, occupational therapists, psychologists, a continence nurse and rehabilitation nurses work with you on walking, bladder and bowel routines, nerve pain and mood, with at least 3 hours of therapy a day. We work closely with your spinal surgeon in Ireland. There is no waiting list: admission can be arranged as soon as your medical records are reviewed. Under the EU Cross-Border Healthcare Directive, the cost is reimbursable by the HSE.
- Led by
- A physician in Physical Medicine and Rehabilitation
- Therapy
- At least 3 hours a day, goals reviewed weekly
- Where
- Near Thessaloniki, Greece, about four hours' direct flight from Dublin
- Funding
- Reimbursable by the HSE under the EU Cross-Border Directive
- Start
- No waiting list, once your records are reviewed
Life after cauda equina surgery, and how rehabilitation helps
The cauda equina is the bundle of nerve roots at the bottom of the spine. They control the legs, bladder, bowel, sexual function and feeling in the "saddle" area between the legs. When something presses on them, most often a large slipped disc, these functions can be affected. Surgery takes the pressure off, but nerves recover slowly, and sometimes only partly.
The long-term effects of cauda equina syndrome are often invisible to others. Many people still have some leg weakness or bladder problems a year after surgery. Bowel changes, nerve pain, numbness, sexual changes and low mood are common too. If this is you, you are not alone.
Rehabilitation does not make nerves heal faster. It helps you make the most of the recovery that comes, and learn routines that make daily life safer and more predictable.
How we support your cauda equina recovery
After surgery, we bring bladder, bowel, sexual-health, pain and mood care together in one programme.
A bladder routine you can rely on
Our continence nurse checks emptying with a bladder scanner and builds your routine with you. Pelvic-health physiotherapy trains the pelvic floor where some control remains.
A bowel routine you can rely on
Daily bowel rehabilitation with our nurses, and meals planned by a dietician. If you need more, we start bowel irrigation and train you to use it.
Sexual health
Our team asks privately and respectfully, and offers sexual-health support for you, and for your partner if you wish.
Leg strength and walking
Daily physiotherapy for strength, balance and walking, with treadmill training and heart-rate monitoring, and body-weight support for more severe weakness.
Water
Our three-pool hydrotherapy complex, once your physician has checked it is safe for you, for example after surgery or with a catheter.
Nerve pain after spinal surgery
Pain management alongside therapy, with our medical team reviewing your pain and your medicines.
Mood and adjustment
Our psychologists, working in fluent English, support you and your family from the start of your stay.
Your cauda equina syndrome rehabilitation programme
Every programme is planned around your goals by a Physical Medicine and Rehabilitation physician, who leads the team and reviews your progress with you every week. Most people work with several of these services each day:
Physiotherapy and robotics
Strength, balance, walking and pelvic-health physiotherapy.
See the service
Bladder and bowel rehabilitation
A continence nurse, bladder scanning and bowel irrigation.
Sexual health
Private, respectful support for you, and for your partner if you wish.
Occupational therapy
Daily tasks, equipment and planning for home.
See the service
Hydrotherapy
Our three-pool complex, once your physician has checked it is safe for you.
See the service
Pain management
Alongside therapy, with our medical team reviewing your pain and your medicines.
Psychology and neuropsychology
Mood, adjustment and family support, in fluent English.
See the serviceA typical day
Bladder and bowel care has its own place in the timetable, rest is built in, and the plan changes as your goals change.
Morning
Your bladder and bowel routine with the nursing team, then physiotherapy for strength and walking.
Midday
Lunch served at your bedside, with time to rest.
Afternoon
Occupational therapy, then hydrotherapy or psychology, depending on your plan.
Evening
Time with your family in the gardens, the lounges or your room.
What to expect during your stay
In the first days, the team assesses your strength, sensation, walking, bladder, bowel, pain and mood, and agrees goals with you in your own words, and with your family if you wish. Realistic goals might be:
Nerve recovery varies from person to person, and we cannot promise how much will return. We can promise to track your progress, review your goals every week and tell you honestly what we see, even when progress is slow. Before you leave, occupational therapy prepares a plan for home, and we send a full report to your GP or spinal surgeon in Ireland.
From the first call to coming home
Most people have never arranged care abroad. This is the whole route, so you know what happens next and who does it.
Before you travel
- 1
Talk to us
Call, send a WhatsApp message or use the form. We explain how the Cross-Border Directive works and what we need from you.
- 2
Send your records
A recent medical summary, your medication list and any recent scans. Our physician reviews them and tells you honestly whether a stay is likely to help.
- 3
Referral and estimate
Ask your GP or public hospital consultant for a dated referral letter; we tell you exactly what it should say. We send a written estimate in English before you commit.
Your stay
- 4
Choose your date
There is no waiting list. Once your surgeon clears you to fly, you choose the date, and we meet you at Thessaloniki airport.
- 5
Consultation and admission
The outpatient consultation with our physician the day before admission, then your programme starts.
- 6
Your stay
At least 3 hours of therapy a day, with your bladder and bowel routine built in and your goals reviewed every week.
Back home
- 7
Home and your claim
You go home with a plan for home, a full report for your doctor and every document the HSE claim needs.
How the HSE reimburses cauda equina syndrome rehabilitation
Cauda equina syndrome rehabilitation at Evexia Plus is reimbursable by the HSE under the EU Cross-Border Healthcare Directive. You don't need a medical card or private insurance.
You pay the hospital
You pay Evexia Plus directly for your stay.
You claim from the HSE
With the documents we give you at discharge.
The HSE repays you
What you paid, up to what the same care would cost in the Irish public system.
What the HSE needs
- 01
A referral letter from your GP, or from a hospital consultant who sees you as a public patient.
- 02Our recommendation
An outpatient consultation, in person, dated after the referral. Have it with our physician in Greece the day before admission: one trip, and no wait for a clinic appointment in Ireland.
- 03Optional
Prior Notification gives an indicative figure, not a guarantee, and with current delays the HSE's reply can take months. We usually advise going ahead without it, because the HSE assesses every claim after treatment either way.
Reimbursable
- The inpatient programme (therapy, nursing care and your stay in the hospital)
- Medicines and tests during the stay
- The outpatient consultation at the HSE's rate
Not reimbursable
- Flights and other travel
- Family travel and accommodation outside the hospital
- Medicines you take home
Before you commit, our team sends a written estimate in English. At discharge, we give you every document the claim needs.
Your family can stay with you
Rehabilitation goes better with the people you love close by. One family member can stay with you free of charge, in your room or in nearby accommodation we arrange.
More relatives can stay in seaside hotels in Kallikratia, five minutes away, and a free shuttle bus runs to Thessaloniki. Airport transfers are free for you and your family, both ways. If you wish, your family can learn your bladder, bowel and movement routines alongside you.
Every member of our staff communicates in English. Meals are cooked in our own kitchen and planned by a dietician, and can be adjusted to support your bowel routine.
See Evexia Plus before you travel.
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Questions about cauda equina syndrome rehabilitation
Can you recover from cauda equina, and how long does recovery take?
Many people improve after surgery, but recovery is slow and often incomplete. It is usually fastest in the first months, and bladder and sexual function can keep changing for more than a year. The length of your stay is set by the consultant at your outpatient consultation and reviewed every week with you. The HSE does not limit the number of weeks it reimburses; it caps the rate.
Will my bladder and bowel control come back?
For many people it improves, but slowly, and often not completely. People who could still pass urine before surgery usually do better. While the nerves recover, the aim is a routine that keeps you safe and confident, so you can plan your day without fear of accidents. Our continence nurse and rehabilitation nurses work on this with you.
Will cauda equina syndrome affect my sex life?
It can, for men and women, and it is one of the most common lasting effects. It is also one of the least talked about, so we raise it privately and respectfully. Our team offers sexual-health support for you, and for your partner if you wish, at a pace that suits you.
When can rehabilitation start after cauda equina surgery?
As soon as your surgical team confirms you are medically stable, ready for active therapy and safe to travel. Nerve recovery is usually most active in the early months, so starting then makes sense. We work closely with your spinal surgeon in Ireland, and there is no waiting list.
Do I need inpatient rehabilitation, or is local cauda equina physiotherapy enough?
It depends on your needs. If your symptoms are mild and well managed, local physiotherapy and continence care may be enough, and we will tell you so. An inpatient stay suits people with several problems at once, such as weakness, bladder or bowel changes, pain and low mood, who want one coordinated team and at least 3 hours of therapy a day.
Can rehabilitation help with nerve pain after spinal surgery?
Nerve pain in the back, buttocks or legs is common after cauda equina syndrome and can continue after a successful operation. Our medical team reviews your pain and medicines alongside therapy, and our psychologists help with the stress it brings. Pain may not go away completely, but we work with you on a plan to manage it.
Can I travel to Greece with a catheter, or soon after surgery?
Many people do, once their surgeon says it is safe to fly. If you use a catheter, carry enough supplies in your hand luggage, with a short letter from your GP listing them. We meet you at Thessaloniki airport, free of charge, and our nurses take over your care when you arrive.
I live outside Dublin. Can I still arrange cauda equina rehabilitation?
Yes. Wherever you live in Ireland, in Cork, Galway, Limerick, Waterford or Dublin, the steps before you travel are done from home: a call or WhatsApp message, your records by email and a referral letter from your own GP. The outpatient consultation can take place with our physician in Greece the day before admission, so no clinic appointment in Dublin is needed.
Does the HSE pay for cauda equina rehabilitation abroad?
Yes, under the EU Cross-Border Healthcare Directive. You pay the hospital directly, then the HSE repays what you paid, up to what the same care would cost in the Irish public system. You need a referral from your GP or a public hospital consultant and an outpatient consultation. Flights and family accommodation outside the hospital are not reimbursable.
Where does the outpatient consultation take place?
You can have it in Ireland with a public hospital consultant, or with our physician in Greece on the day before admission. We recommend the second: you make one trip and avoid waiting for a clinic appointment. Either way, it must take place after the date on your referral letter.
Can my family stay with me?
Yes. One family member stays free of charge, in your room or nearby accommodation we arrange. More relatives can stay in seaside hotels five minutes away, family can visit every day, and airport transfers are free for you and your family. Your family can learn your routines alongside you, and our psychology team supports them too.
