Caudal Steroid Injection

Nerves running from your spinal cord down to your legs can become irritated anywhere along their length. When they are irritated at the roots – where they meet the spinal cord – the result can be significant back or leg pain. That pain can be relieved with a procedure known as caudal steroid injection.



Caudal injection is appropriate for lower back pain and leg pain related to herniated discs, bone spurs, sciatica, and a number of other lower back problems. We utilize steroids to calm the nerves and reduce inflammation. This results in pain relief.


How the Procedure Is Performed


The first step is for the patient to lie face down on the treatment table. We place a cushion under the abdomen in order to elevate the targeted area. Then a local anesthetic is applied to numb the skin and tissue directly underneath.


Once the anesthetic has taken hold, a thin needle is inserted and guided toward an opening known as the sacral hiatus. This opening gives the doctor access to the sacrum. Guiding the needle through the sacral hiatus allows it to enter the caudal epidural space where the inflamed nerves are located.


The doctor typically injects a dye solution in order to better see where the nerves are located. A fluoroscope further aids in finding the right injection location. Once the doctor is comfortable with the position of the needle, the actual medication is injected. In most cases, this is a combination of anesthetic and steroids.


The needle is then removed, and the site bandaged. It is normal for patients to experience some pain and slight bruising at the injection site. After a brief recovery time, the patient can return home. The entire procedure only takes about 15 minutes from start to finish.


What Patients Can Expect


It is not unusual for patients to report less pain within just 30 minutes of the procedure. However, pain may intensify as a result of the anesthetic wearing off. Long-term pain relief generally kicks in within two or three days of the injection. It takes that long for the steroids to sufficiently reduce inflammation.


Some patients report significant pain relief only for a few weeks. Others report months of relief. There is no definitive time frame because patients react to caudal steroid injections differently. Discuss any such concerns you have with your doctor before undergoing the procedure.


Your doctor is likely to recommend that you avoid driving or strenuous activity with the first 24 hours of your procedure. After that, you can return to normal activities as you feel you are ready.


Complications and Side Effects


Caudal steroid injections are safe and effective. Furthermore, the risk of complications is low. Most patients experience minor pain and bruising at the injection site. This is normal for all treatments involving needles. When more serious side effects do occur, they are generally limited to injection site infection, bleeding, and headache.


If you think a caudal steroid injection procedure is right for you, please visit one of our doctors. We want you to make the right choice as you seek to find long-term pain relief. Lone Star Pain Medicine can help you make that choice by advising you of the most appropriate treatments for your type of pain.