A caudal epidural steroid injection is an outpatient procedure for treating lower back and leg pain. A corticosteroid (anti-inflammatory medicine) is injected into the epidural space to reduce the inflammation causing pain.
A protective covering known as dura covers the spinal canal. The space that surrounds the dura is known as the epidural space. The nerves that originate from the spinal cord pass through the epidural space.
Soft discs are found between the vertebrae and cushion them during movement. If a disc tears, chemicals inside may leak out. This can irritate the nerve roots and cause pain. When these nerves are irritated, they can cause pain in the lower back that goes down the legs. In addition, bone spurs (growth), called osteophytes, can also press against nerve roots and cause pain.
If you have pain in your lower back when you move, you may have caudal disc and dural inflammation. If pain travels to your legs, you may have nerve root inflammation.
The common tests that are usually done include such as x-rays or MRIs which may show disc bulges and nerve root compression. A caudal epidural injection may provide relief if disc problems, or dural, or nerve root inflammation are causing your pain.
During the procedure
The physician numbs your skin with local anesthetic. Under X-ray guidance, a thin needle is advance into the opening in the tailbone call the caudal epidural space. To ensure proper placement of the needle, the physician will inject contrast dye.
Once proper position of the needle has been confirmed, the medications consisting of local anesthetic and corticosteroid are injected and the needle is removed.
After the procedure
You will be monitored for a half an hour after the Caudal Epidural Steroid Injection. When you are ready to leave, the staff will give you discharge instructions.
You may feel immediate pain relief and numbness in your lower back and legs for a period of time after the injection from the local anesthetics. This may indicate the medication has reached the right spot. Your pain may return after this short pain-free period, or may even be a little worse for a day or two. It may be caused by needle irritation or by the corticosteroid itself. Corticosteroids usually take two or three days to start working, but can take as long as a week.
You should take it easy for the rest of the day. You may feel sore for a few days.
How long will pain relief last?
The extent and duration of pain relief may depend on the amount of disc, dural or nerve root inflammation. Other coexisting factors may be responsible for your pain.
Sometimes an injection brings several weeks to months of pain relief, but further treatment may be needed.