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Caudal Epidural Injection for back pain treatment

Updated: Jan 2

What is a Caudal Epidural Injection?

A Caudal Epidural is an injection used for back pain treatment. The injection is done at the base of the spine near the coccyx. The spinal cord and spinal nerves are contained within a fluid-filled sack surrounded by a membrane which is called the dural membrane. An epidural injection aims to spread the injected substance just outside this membrane (sleeve-like area that surrounds your nerve roots). 

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Why is it done?

Epidural steroids are administered for lower back and/or nerve pain in the legs.

What conditions does a caudal epidural injection treat?

A caudal injection treats nerve pain and inflammation. Causes of nerve pain and inflammation may include:

  • Spinal canal stenosis

  • Radiculopathy

  • Herniated disc 

  • Degenerative spine condition

  • Failed back syndrome or failed back surgery syndrome

How does caudal epidural injection work for back pain treatment?

The injection we use is a combination of a local anesthetic and steroid medication. Local anesthetic helps to numb the nerves, giving short-term pain reduction, whereas steroids have a long-term effect by reducing inflammation and irritation of the nerves. The injection may also have a physical effect by increasing the space around the compressed nerves.

How is it done?

A caudal epidural injection is performed as a day-case procedure and is generally considered one of the most risk-free procedures for pain management. Before the treatment the risks and benefits will be discussed with you individually in the out-patients clinic. On the day of the epidural injection, you will be admitted to the ward. Before the procedure, you will be seen by your doctor and will be able to ask any further questions. Shortly before the procedure, you will need to change into a hospital gown. For the caudal epidural injection, you will be transferred to the operating room. 

In the operating room:

1. You lie face-down on an X-ray table. The site of the injection is sterilized usually using betadine or chlorhexidine solution. 

2. A neurosurgeon will inject a local anesthetic into the skin and soft tissue of your lower back to numb the area for the caudal epidural injection. 

3. Then the needle is placed in the epidural space and a x-ray-sensitive contrast is injected. X-ray is used to confirm the correct positioning of the needle.

3. After the confirmation, steroid medication mixed with anesthetic and saline is injected into your epidural space.

5. The needle is removed and a small dressing is applied at the site of injection. The entire process usually takes 15 to 30 minutes and is largely pain-free.

What happens after a caudal injection?

A caudal epidural injection is an outpatient procedure, meaning you can go home the same day. Typically, you need to avoid strenuous activity for the first 24 hours after the injection. While largely pain-free, you may notice some soreness near the injection site for a short while. Most people experience highly effective pain relief within a few days after the procedure.

Very Rarely (in less than 2% of cases) a caudal epidural injection cannot be performed because the individual patients’ anatomy in this area can vary or be too complex to proceed safely. In this case other treatment options will be discussed.

If you suffer from the back pain or other related symptoms, do not hesitate to contact us for consultation:

Tel: +995 599820404

About Dr. Archil Eristavi:

Dr. Archil Eristavi is a board-certified neurosurgeon with over 20 years of experience in the field. His experience includes 9 years of work as a neurosurgeon in London, UK. He specializes in the treatment of brain and spinal conditions such as brain and spinal tumors, vascular pathologies of the central neural system, traumatic injuries, degenerative disease of the spine, and disorders of the peripheral neural system. Dr. Eristavi has a clinical experience of over 1500 intracranial and spinal surgeries.

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