Frequently asked questions about Caudal Steroid Injection
What is a caudal steroid injection?
This type of injection is for pain in your back, groin, or rectal area. It is an injection that goes into the base of your spine and contains a local anesthetic as well as a steroid. The local anesthetic will provide immediate relief and the steroid will provide long lasting relief.
How do you perform a caudal steroid injection?
The patient is told to lie down on the table on her stomach. While on the table she is given a medication through an IV to make her relax. Then the doctor will numb the area in her lower back. This area is also called the small of the back. After looking at an x-ray, the doctor put a very tiny needle into your back at the very base of your spinal column.
Many doctors have begun using a fluoroscopic guidance tool to help locate the appropriate place to insert the needle. This has taken the guessing out of the procedure and made successful results much more apparent. Then he will inject a dye into your lower back to make sure the needle is placed in the proper space. Once that is done, the doctor will inject an anesthetic for immediate relief and a steroid for long lasting relief.
Are there any risks to the procedure?
The risks associated with this procedure are very small. There are some uncommon complications such as bleeding or infection at the point of entry into the spine. The patient may possibly feel a slight headache if the dura ended up getting punctured. This is quite unusual for this type of injection.
How successful is the caudal steroid injection?
Many patients have relief from pain as soon as 30 minutes after the injection. Pain does sometimes return though once the local anesthetic wears off. The expected relief usually doesn’t happen until two or three days after the procedure. It takes that long for the steroid to start to make a difference in the inflammation of the area.
What can be expected after the procedure?
It is recommended that you don’t do any strenuous activity for the rest of the day after your procedure. Relax at home and give the steroids time to begin to work. The next day, you can resume your normal activities. Sometimes it takes up to 7 days for the steroid to begin having any effect that a patient can feel. If there is no significant improvement in pain after 2 weeks, call your physician to see if he wants to run some tests. The procedure may not have been as successful as he would have hoped and he will want to talk to you about alternative methods of treatment.
Should I take the caudal steroid injection?
It may be wise to try the caudal steroid injection if you have already tried the routine methods of treatment such as anti-inflammatory drugs, physical therapy, heat, ice, and cortisone shots. If none of them have provided the relief you are seeking and it has been longer than a month, then you may want to think about trying the injection.
Dere, K., Akbas, M., Bicerer, E., Ozkan, S., & Dagli, G. (2009). A complication during caudal steroid injection. Journal Of Back & Musculoskeletal Rehabilitation, 22(4), 227-229. doi:10.3233/BMR-2009-0236