Caudal Epidural Steroid Injection


This outpatient procedure is an injection of a steroid-anesthetic medication through an opening in the sacrum. The medication can reduce swelling and inflammation of irritated spinal nerves. The injection takes only a few minutes to complete.

Patients may experience relief within a half hour of the injection, but long-term relief is typically felt within 2-3 days after the procedure. Each caudal injection may last for several weeks to several months, and patients typically have varied results concerning the longevity of their pain relief. Physicians may recommend further treatments of this type in cases where the pain is chronic or recurrent.

Patients are encouraged to ask questions. We feel that an open line of communication enhances the level of care we can provide and improves the overall experience. If you are uncomfortable with any aspect of your pain management feel free to ask. Be sure to inform the medical team about anything affecting your health. Patients are advised to eat only a light meal prior to the procedure and should bring along a list of any current medications being taken. Those taking blood thinners will often be advised to temporarily discontinue using such prescriptions about two weeks prior to having a caudal steroid injection. In preparation for the procedure, the patient lies face down. A cushion is placed under the abdomen to elevate the sacrum.

Once in position, our staff will administer local anesthesia to the injection site, which is called the sacral hiatus. The sacral hiatus is located just above the opening at the base of the spine. The purpose of this step is to numb the injection area to make the caudal steroid injection less uncomfortable for the patient.

When the area is numb, the physician guides a needle through the sacral hiatus and into the caudal epidural space. This is the open space in the sacrum where the irritated nerve roots are located.

The physician injects contrast solution through the needle. The physician uses a fluoroscope (a type of x-ray device) to confirm that the tip of the needle is positioned correctly within the epidural space.

After the needle's position has been confirmed, the physician injects a steroid-anesthetic medication. This medication bathes the irritated nerve roots. It will help alleviate the patient's pain.

When the procedure is complete, the physician removes the needle and bandages the insertion site. The patient may feel significant relief after one injection. Some patients may need multiple injections before they feel the full benefit of the medication.

It is not advised to do any rigorous activities or drive for approximately 24 hours after a caudal steroid injection. However, normal activities may typically be resumed the next day.









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