Caudal epidural steroid injections (Caudal ESI) help reduce inflammation and alleviate pain located in the lower back. Medical professionals typically recommend steroid injections when other treatment options, such as rest, physical therapy, and other medications, do not provide patients with the pain relief they seek.
These injections treat chronic lower back or leg pain caused by:
This non-surgical option relieves pain and inflammation in your back.
Before your procedure, talk to your doctor about what medication you’re taking. You may need to discontinue or briefly change your dosage of certain medications such as blood thinners or immunosuppressant medicines prior to your injections.
During the procedure, you’ll be asked to lay on your abdomen on an X-ray table. The medical professional administering your injection will numb the skin on your lower back with a local anesthetic, and you may be given general anesthesia via an IV depending on your pain or comfort levels.
Once the anesthesia takes effect, the healthcare professional, guided by the X-ray, will insert the needle into the lowest portion of the epidural space on your back and inject the medication into the area between the membrane containing spinal fluid, known as the dura, and the thickest ligament between your vertebrae. The continuous X-ray ensures medical professionals inject the steroid into the proper place in your back.
The outpatient procedure typically takes less than thirty minutes.
Following your injection, you’ll need someone else to drive you home–you will be unable to drive for about a day. Some patients feel immediate pain relief while others feel relief after a week. You may experience an increase in pain in your lower back where the needle entered, but this temporary pain dissipates within two to three days of the injection. If this pain becomes bothersome, you can place an ice pack on it to relieve the pain.
If you do not see any improvement following your injection within 10-14 days, contact your doctor to discuss the next steps. The duration of pain relief provided by these injections varies among patients, and some patients may need to have these injections regularly.
The risk for serious complications is very rare but can include bleeding, infection at the injection site, and headache. If you notice these, contact your doctor.