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Caudal Epidural Steroid Injection


What is a Caudal Epidural Steroid Injection?  

A caudal epidural steroid injection is a minimally invasive, outpatient procedure used to treat pain caused by inflammation of the spinal nerves in the lower back and legs. During the procedure, a steroid-anesthetic medication is injected through a small opening at the base of the spine (the sacral hiatus) and into the epidural space surrounding the irritated nerve roots. 

How is a Caudal Epidural Steroid Injection Performed?  

To perform a caudal epidural steroid injection: 

    1. 1. The patient lies face-down, with a cushion placed under their abdomen to elevate the sacrum. 

    1. 2. The physician administers a local anesthetic to numb the skin and tissue over the sacral hiatus. 

    1. 3. Using fluoroscopic (X-ray) guidance, the physician inserts a small needle through the numbed area and into the caudal epidural space. 

    1. 4. A contrast dye is injected through the needle to confirm proper placement within the epidural space. 

    1. 5. Once the needle position is verified, the physician injects the steroid-anesthetic medication into the epidural space to reduce inflammation and pain. 

What Supplies and Medications are Used for a Caudal Epidural Steroid Injection? 

The key components of a caudal epidural steroid injection include: 

    • – Local anesthetic (e.g., lidocaine) to numb the injection site 
    • – Contrast dye to visualize the epidural space and confirm injection location
    • – Corticosteroid medication (e.g., triamcinolone, dexamethasone) to reduce inflammation and provide long-term pain relief 
    • – An anesthetic medication (e.g., bupivacaine) to provide short-term pain relief 

The physician selects the specific medications and doses based on the patient’s individual needs and condition. 

What to Expect After a Caudal Epidural Steroid Injection?  

After the procedure, the patient may experience some tenderness or discomfort at the injection site, but this is typically mild and resolves within a few days. Patients may feel significant pain relief within a few days to a week, as the steroid medication takes effect and reduces inflammation. 

Some patients may require multiple injections over time to maintain the benefits. Your provider will provide instructions on any activity restrictions or follow-up care. Patients should report any concerning symptoms, such as increased pain, numbness, or weakness to their healthcare provider.

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