Caudal Epidural Steroid Injection

An epidural steroid injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, hopefully reducing the pain in the back or legs.  The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury/cause of pain is healing.

General Pre-injection Instructions:

Be sure to inform our staff if you have an allergy, particularly to iodine.  If you will be receiving sedation, you should NOT eat the morning of the procedure.  If a patient is an insulin dependent diabetic and receiving sedation, they may need to change their morning dose of insulin to account for not eating the morning of the procedure.  Patients may take their routine medications (i.e., high blood pressure and diabetic medications, e.g. Glucophage).

Patients should continue to take pain medications or anti-inflammatory medications the day of their procedure.  If a patient is on Coumadin or another blood thinner, they should notify the staff so an appropriate plan can be made for stopping the medication before the procedure.  We generally recommend that a driver should accompany the patient and be responsible for getting them home.

Caudal Epidural Steroid Injection Procedure:

The patient is positioned on their stomach so the spine can be viewed under x-ray. The skin on the back is scrubbed using antibacterial soap. Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a needle into the epidural space. A mixture of numbing medicine (local anesthetic) and anti-inflammatory (steroid) is injected.

What happens after the procedure?

There are no restrictions to food or liquid intake or to activity level unless specified by the physician.  A follow-up appointment will be made for a repeat block if indicated. These injections are usually done in a series of three, about one month apart.  The back or legs may rarely feel weak or numb for a few hours. Patients may return to their normal activities on the day of the procedure. Driving is discouraged on the day of the procedure.