A caudal epidural steroid injection is typically done to treat chronic back and lower extremity pain. The procedure is performed at the base of the spine and involves the injection of a steroid anesthetic medication through an opening in the sacrum. This outpatient procedure works to reduce pain caused by irritated spinal nerves.
Common conditions that caudal epidural steroid injections are used to treat include:
How is the Procedure Performed?
Caudal epidural steroid injections usually take less than 15 minutes to perform and are a minimally invasive procedure. To prepare for the injection, the patient lies down on their stomach with a cushion placed underneath the abdomen to elevate the sacrum. First, a local anesthetic will be applied to the skin and tissue above the treatment site for increased comfort during the procedure.
Nest, using a live x-ray (fluoroscopy) device, your doctor will guide a needle through the sacral hiatus (a small boney opening just above the tailbone). This approach allows the needle to be placed at the very bottom of the epidural space. The epidural space is a fat filled ‘sleeve’ that runs the length of the spine. It is located between the outermost tissue layer and the inside surface of the bone, providing cushioning for the spinal cord and nerves.
Once the needle has been advanced into the caudal epidural space, your physician will inject a contrast solution through the needle. Using the real time x-ray device, your doctor will observe the flow of the contrast dye to ensure that the tip of the needle is positioned correctly. Once this has been confirmed, a second injection containing a mixture of steroid medication and local anesthetic will be administered.
Upon injection, the medicine bathes the irritated nerve roots. Patients typically experience immediate pain relief due to the local anesthetic. After the numbing medicine wears off, some patients may notice an increase in pain before the cortisone begins working. For most patients, the steroid medication begins providing more sustained pain relief within 3 – 5 days after the procedure. This varies from patient to patient however. Generally, improvement will occur within 10 days of the injection.
If the initial caudal epidural steroid injection goes well for the patient, the physician may recommend a series of steroid injections to be administered over the course of a few months. ESIs can provide significant alleviation from painful symptoms by reducing inflammation and irritation while disrupting the pain-spasm cycle. This provides patients with a period of pain relief so that other treatments like physical therapy can be more effectively carried out.
Schedule an Appointment at the Diagnostic Pain Center in Austin
The best way to find out if you are a good candidate for caudal epidural steroid injections is to schedule an appointment with an Austin pain management physician, Dr. Robert S. Marks or Dr. Sauman A. Rafii. If you are experiencing lower back, rectal, groin or leg pain, then caudal ESIs may be an effective treatment for you. Please call (512) 981-7246 or click on the appointment request button to schedule an evaluation with Dr. Marks or Dr. Rafii.