Caudal injection

Overview

Caudal injections are a specific type of epidural injection used in the lower back. They are administered into the lower part of the epidural space, which surrounds the nerve roots. These injections deliver a steroid medication aimed at reducing inflammation and alleviating low back pain effectively. This treatment is especially advantageous for those with chronic back pain or conditions like sciatica, improving their quality of life.

A caudal injection is an outpatient procedure. Patients usually experience relief within a few days, requiring minimal downtime.

Reasons for undergoing the procedure

Caudal injections treat nerve pain and inflammation by injecting medicine into the epidural space. Spinal nerves run through the epidural space to connect with the legs, and if these nerves become inflamed, it can cause leg or back pain.

Nerve pain and inflammation have several causes that can be treated with caudal injections. This include:

• Sciaticaor radiculopathy
• Degenerative disk disease
• Herniated disk
• Spinal canal stenosis
• Postlaminectomy syndrome or failed back syndrome

Risks

Generally, caudal injections are considered very safe, with only a few minor risks. Similar with any medical procedure, caudal injection also carries risks, such as:

• Infection
• Bleeding
• Headache

Before the procedure

The healthcare provider will give guidance on what to do before a caudal injection. This may include:

• Providing a complete health history
• Sharing all current medications and supplements
• Stopping blood-thinning medications a few days before the injection
• Arranging a ride home, as driving is prohibited for at least 24 hours after the injection

During the procedure

Caudal injection often begins with applying a numbing anesthetic to the lower back. The patient usually lies face-down on an X-ray table, possibly with a pillow under the abdomen for added comfort.

The procedure then proceeds as follows:

• A needle is used to inject dye into the epidural space, and an X-ray guides the healthcare provider to the precise location for the medication
• A steroid medication is then injected into the epidural space using a needle

After the procedure

Following a caudal injection, patients may experience soreness around the injection site and are advised to refrain from strenuous activities and driving for the initial 24 hours. Typically, relief from back pain is expected within two to three days following the injection.

A caudal injection typically lasts between 15 to 30 minutes. It is performed on an outpatient basis, allowing patients to return home on the same day.

Outcome

By alleviating discomfort, these injections can facilitate participation in therapies like physical therapy. Healthcare providers can guide patients in integrating injections into a comprehensive pain management plan. Overall, caudal injections are often successful in managing pain, improving function, and potentially avoiding surgical intervention.

Following a caudal injection, individuals can typically resume normal activities within 24 hours. While some experience pain relief within a few days, it may take up to 10 days to notice improvement.

Some individuals find significant relief after a single cortisone injection. If pain persists, up to two additional injections, spaced two to four weeks apart, may be recommended to maximize effectiveness. Periodic steroid injections several times a year may also be necessary for some.

Persistent back pain beyond two weeks should prompt consultation with a healthcare provider. Exploring alternative steroids or medications for more effective relief may be recommended.

Other pain management treatments include:

• Hot and cold therapy
• Massage therapy
• Muscle relaxants
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Physical therapy
• Surgical procedure such as laminectomy or spinal decompression surgery