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Caudal Epidural Injection

What is the epidural space and epidural injection?

Nerves travel through the epidural space before they travel into your legs. The nerves leave the spine from small nerve holes. These nerves may become inflamed due to irritation from a damaged disc or from contact with a bone spur. Inflammation of these nerves may cause pain in your low back, hip, buttock, and legs.
An epidural injection places anti-inflammatory medicine (cortisone) into the epidural space to reduce nerve inflammation, and hopefully, reduce your symptoms. By stopping or limiting nerve inflammation we may promote healing and reduce pain.

Some quick information

  • First, an IV is started so that you may be given medicine for relaxation if you so desire. Next, while lying face down on an x-ray table your skin will be well cleansed with an antiseptic. The physician will numb a small area of skin where the epidural needle will be inserted. The injection will occur at the top of the buttock crease where there is a small opening to the epidural space. Next, the physician will use x-ray guidance to direct a small needle into the epidural space. There will be pressure felt with this part of the procedure. He will then inject contrast dye to confirm that the medicine spreads to the affected nerve(s) in the epidural space. After this, the physician will inject a combination of numbing medicine (anesthetic) and time released anti-inflammatory (cortisone).

  • You may have some partial numbness in your buttocks and/or legs from the anesthetic after the injection. This may last several hours but you will be able to function safely if you take precautions. You will report your remaining pain (if any) and record the relief you experience over the next week in a pain diary. 

    You may notice an increase in your pain lasting for several days. This occurs after the numbing medicine wears off but before the cortisone has a chance to work. Ice will typically be more helpful than heat during this time. You may notice an improvement in your pain 3 to 5 days after the injection. Improvements will generally occur within 10 days after the injection.

    On the day of the injection, you should not drive, and should rest and avoid any strenuous activities. You may take your regular medications at their usual times after the procedure including your pain medicine if needed. On the day after the procedure, you may return to your regular activities. When your pain was improved, start your regular exercise in moderation. Even if you are significantly improved, gradually increase your activities over 1 to 2 weeks to avoid recurrence of your pain.

Our goal is to help the patient regain their quality of life

We relieve your pain, helping you be yourself again!