Caudal Epidural Steroid Injection
This procedure is well suited to relieve pain from ‘pinched nerves’ in the spine. The nerve can be impinged or pinched due to multiple possible causes. The nerve or nerve root then swells due to this condition and the pain radiates along the path of the nerve causing pain in the places where the nerve endings terminate. The effect of the injection is too place anti-inflammatory steroid medication near the source of the painful swelling and decrease the pain by helping the nerve return to its normal state.
This procedure is indicated for radicular type pain coming from ‘pinched’ nerves in the spine. The caudal approach is best used for lower lumbar or sacral nerves. It also is good for patients with leg pain that have had major lower back surgery, as it can avoid scar tissue. Lumbar radiculopathy, lumbar stenosis, spondylosis with myelopathy, back injury, HNP or herniated disc of the lumbar spine, nerve root injury of the lumbar or sacral spine, coccyx pain or other lumbar/pelvic conditions that would cause nerve or nerve root swelling in the lower spine are all well suited for treatment with this procedure.
What to Expect
The patient can expect to have the procedure done while gaining access to the back. Usually this is done while lying face down and having fluoroscopic guidance for the placement of the needle into the central epidural space from the caudal canal located near the top of the buttock. Local anesthesia to numb the skin and injection of steroid are usually done as an outpatient or office procedure without sedation needed.
The procedure may take several days to get enough of the nerve swelling down in order to understand how the pain relief will take effect. The pain relief can last for several weeks to months or even longer. If the area is reinjured or the nerve is impinged again, the pain may recur and the procedure can be repeated as indicated.