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Caudal Epidural Steroid Injection

Epidural Injections

Injection of an anesthetic substance into the epidural space of the spinal cord. The injection may consist of steroids that intercept the production of painful inflammatory substances and/or a lidocaine or saline solution to help get rid of inflammatory proteins around the affected area. This is a common nonsurgical treatment option to alleviate pain caused by lumbar disc herniation, degenerative disc disease and lumbar spinal stenosis. The pain-killing effect of this injection is temporary and commonly used in combination with a rehabilitation program to provide additional relief. Types of epidural injections that we perform are:

  • Epidural Blood Patch injection of patient’s blood into the epidural space
  • Interlaminar Epidural Steroid Injection – delivery of injectate to the epidural space by directing a needle between the laminae of two adjacent vertebrae.
  • Transforaminal Epidural Steroid Injection – Injection of a steroid (synthetic cortisone) medication into the epidural space.
  • Caudal Epidural Steroid Injection – Injection into the lowest portion of the epidural space.

Procedure

First, you will lie on your abdomen on an x-ray table. Then, an intravenous medication to help you relax will be administered.

The doctor will numb an area of skin on your lower back, just above your buttocks, with a local anesthetic. Then, guided by an x-ray, he or she will:

  • Insert a thin needle into your back, just above your tailbone
  • Inject dye to confirm that medication is administered into the caudal space
  • Inject a mixture of anesthetic (for temporary pain relief) and steroid (for longer term relief) The medicines then spread in the epidural and caudal spaces, thereby hopefully reducing nerve inflammation and pain.

Usually, the procedure takes less than 15 minutes and you can go home the same day.

After the Procedure

Do not drive or do any rigorous activity for 24 hours after your caudal injection. Take it easy. You can return to your normal activities the next day.

You can continue your regular diet and medications immediately.

It may take up to a week for the steroid to begin working. If you don’t feel better within 10-14 days, see your doctor for additional evaluation and to discuss different treatment options.

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