Caudal Epidural Steroid Injection

What is the Epidural space?
The duramater is a protective covering of the spinal cord and its nerves. The space surrounding the duramater is called the epidural space. In the lumbar area, it is called the lumbar epidural space. The Caudal area is in the sacral area and Sacral hiatus is an opening in the tailbone area.

Causes pain in the Epidural space
The lumbar area of the spine has five bones, called vertebrae. Soft discs found between them cushion them, hold them together, and control motion. If a disc tears, chemicals inside may leak out. This can inflame the duramater or nerve roots and cause pain. A large disc tear may cause a disc to bulge, inflaming the duramater and nerve roots, and cause pain. Bone spurs, called osteophytes, can also press against nerve roots and cause pain.

Procedure Detail
You may be given oral Valium or IV (intravenous) medication to help you relax. You may lie down with face down on the procedure table. The lumbosacral spine and sacral hiatus is identified under fluoroscopy (a type of X-ray is used to ensure the safe and proper position of the needle). A local anesthetic is used to numb your skin. Then a Spinal needle is inserted into the Sacral Hiatus in the tailbone area. The needle is advanced until it reaches the S1 level. Then medication is injected into the epidural space of the spine next to the exiting nerve(s) that are the likely cause of your pain in low back, hips and/or legs.

Why is a Caudal Epidural Steroid Injection Procedure helpful?
It is helpful in the diagnosis and treatment of your low back, hips and/or leg pain, which is likely due to a disorder of your lumbar spinal cord and exiting nerve(s). Medications used for the injection: a local anesthetic and a long-acting anti-inflammatory steroid agent. At first, you may or may not experience temporary pain relief after the injection. Then, after 48 to 72 hours, you will likely experience pain relief after the injection due to the effects of the long anti-inflammatory steroid agent.

Post Procedure
You will be observed for at least 10-15 minutes in the recovery room for your response to the injection. Your oxygen level, blood pressure, pulse rate, and respiratory rate will be monitored in the recovery room. You may become a little sore at the soft tissues of the procedure site, which is normal and to be expected. You may apply ice-pack to the sore area of the procedure site. The soreness at the procedure site should go away in a couple of days. It usually takes 48 to 72 hours to experience relief from the long-acting anti-inflammatory steroid agent. A follow-up appointment will be made for you.

When can I go to work after a Lumbar Epidural Steroid Injection Procedure?
You can return to work the next day.

How long can I expect pain relief?
Depending on the amount of inflammation, an injection could offer pain relief for a few weeks to a few months. For some, a single injection could result in long-term pain relief. If your pain is caused by injury to more than one area, only some of your symptoms will be helped by a single injection. The epidural injection may need to be repeated 3-4 times after a few weeks or months depending on individual’s pain.