Caudal Steroid Injection

Unfortunately, low back pain is an incredibly common condition that the majority of people can expect to experience at some point in their life. While the majority of back pain is caused by an acute injury, such as a difficult workout or slipping and falling, there are cases where pain becomes chronic. Due to the fact that there are a multitude of reasons why a person might experience low back pain, diagnosis can become complicated and treatment even moreso. This is where a caudal steroid injection proves helpful. If you have low back pain, and even subsequent leg pain, the Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas can help to best diagnose and treat your symptoms and underlying cause, with the goal to help you experience a pain-free life as quickly and comfortably as possible. 

What is a Caudal Steroid Injection?

A caudal injection is an injection of medication, usually a steroid and an anesthetic, into the epidural space of the lower back, very near the tailbone. The epidural space is the area around the nerve roots near the spinal canal. The reason why this space is targeted for this particular type of injection is that it is where the nerves branch out to provide sensation and motor activity to both the lower back and legs. 

The injection of steroids helps to reduce inflammation and the anesthetic helps to reduce pain. The goal of the injection is to treat chronic low back pain as well as lower extremity pain. It has proven helpful for patients who have been experiencing low back pain and leg pain and have yet to find relief from other conservative or at-home methods. 

What Conditions Does a Caudal Steroid Injection Treat?

A caudal injection is most helpful at treating nerve pain and inflammation in the lower back that leads to lower back pain as well as lower extremity pain. Most people describe this pain as pins and needles, or sharp and shooting. 

The actual term for this specific type of pain, which begins in the lower back and radiates through the buttock into the legs, is sciatica or lumbar radiculitis. Instead of categorizing it by a certain condition, this type of pain is described by pain, weakness or sensory changes along the sciatic nerve. By injecting medication into the lower back, patients are able to experience pain relief in all three (lower back, buttock and legs) areas of the body by reducing inflammation and irritation that is usually caused by the following conditions:

• Herniated and bulging discs: due to the facts that the discs located between each vertebrae in the spine are flexible and pliable, they have a tendency to herniate or bulge out of place due to excessive pressure, which can cause irritation to nearby nerves. In fact, a herniated disc is one of the most common causes of lower back pain and sciatica. 
• Degenerative lumbar spinal stenosis (DLSS): this disorder is due to the narrowing on the spinal canal in the lower back, which leads to nerve impingement and subsequent pain. Spinal stenosis is most often due to wear and tear over time and is commonly seen in older aged adults. Symptoms include difficulty walking, chronic back and leg back, decreased sensation in the legs, and decreased activity level. It’s important to note that when the nerves in the lower back don’t have relief through medication or treatment, it can lead to a chronic pain syndrome.
• Failed back surgery syndrome (FBSS): a condition that causes patients to experience pain after back surgery that continues after surgery. The pain can be chronic, dull or sharp, aching and burning, and can affect the back, neck, or legs.
• Degenerative disc disease (DDD): a chronic condition that occurs when the spinal discs wear down and cause pain

What Does a Caudal Steroid Injection Involve? 

A caudal steroid injection is a minimally-invasive out-patient procedure, which means you’re  able to return home the same day.

After lying face down on the X-ray table, the provider will sterilize the injection area to reduce the risk of infection. Most patients receive a mild intravenous sedative to relax them before an anesthetic is injected into the lower back to numb the area. The provider will then use fluoroscopic guidance to inject a dye into the epidural space to confirm the correct placement for the medication. Once confirmed, the medication is injected. 

Most patients experience immediate pain relief. Patients are encouraged to rest for the remainder of the day and use ice packs and pain medication if needed. Patients can expect to resume normal daily activities the following day, and can expect total pain relief within two weeks. 

It’s helpful to note that the most important benefit of a caudal steroid injection is that it allows patients to experience enough pain relief where they’re able to enjoy additional treatment options, such as physical therapy, so that they can avoid additional pain symptoms in the future. They can also more comfortably enjoy an active lifestyle while their provider works to determine and treat the underlying cause of pain. 

What are the Benefits and Risks of Caudal Steroid Injections?

The main benefit of a caudal steroid injection is that it is a minimally-invasive treatment that provides patients with immediate and long-lasting relief, all with minimal side effects. Due to the location of the injection, patients who are suffering from several lower back symptoms can find relief from one injection. An added benefit is that this injection can help people to avoid back surgery, or eliminate their need for back surgery all together. 

As with any medical procedure, there are risks. While minimal, the risks with a caudal steroid injection include bleeding and infection at the injection site, headaches and possible nerve damage. There are also risks associated with the medication itself, which include high blood sugar, allergic reaction etc. It’s important to partner with a trained pain management specialist who uses the best tools and reviews your complete medical and health history with the goal to avoid these risks and complications in the first place. 

If you have been suffering from low back pain and leg pain for several weeks without relief from at-home methods, it’s important to seek help from a medical professional. The Nevada Advanced Pain Specialists in the Reno, Sparks and Carson City areas team is well equipped to diagnose and treat all forms of lower back and lower extremity pain, and can help determine if a caudal steroid injection is right for you. Please schedule an appointment today!

Caudal Epidural Steroid Injections are a combination of a steroid and a local anesthetic that is delivered to your lower back to treat chronic back pain and lower extremity pain.

The most common conditions treated are:
Sciatica/Lubar Radiculitis – This is a condition that is characterized by pain, weakness, or sensory changes along the sciatic nerve pathway in the lower extremity. Pain typically radiates down the back of the buttock into the lower extremity. Some people describe the sensory changes as “pins and needles” and the pain is described as “sharp shooting pain”.

Herniated/Bulging Disc (most common cause of sciatica) – Separating each individual vertebrae (spine bones) are discs that act as cushions that minimize the impact that the spinal column receives. Since the discs are designed to be pliable and provide support, they have a tendency to herniate backwards through the outer ligaments and cause irritation to adjacent nerves. Disk disease is one of the most common causes of chronic lower back pain and accounts for approximately 10% of all low back pain complaints.

Degenerative Lumbar Spinal Stenosis (DLSS) – A disorder due to narrowing of the spinal canal diameter which causes nerve impingement. Spinal stenosis can result in persistent pain in the lower back and lower extremities. Those affected often complain of difficulty walking, chronic back and leg pain, decreased sensation in the lower extremities, and decreased physical activity. Many people with spinal stenosis present with bilateral (both left and right) lower extremity pain radiation.

Nevada Advanced Pain Specialists is recognized as an industry leader in pain management. We have a state-of-the-art facility in Reno, Nevada, that allows for us to offer the highest possible level of quality care of our patients.

We are committed to providing a comprehensive and multi-disciplinary approach for each individual’s pain complaints to provide the most appropriate care. Our approach includes analysis of biomechanics, joint motion, as well as skeletal, nerve and muscle tissues. Every individual is evaluated for the root cause of their pain – not just a “quick fix” approach to only provide symptomatic relief.

Your pain will be evaluated with latest diagnostic tools and technologies used by the professionals at Nevada Advanced Pain Specialists to make accurate assessments including: EMG/Nerve testing, MRIs, x-rays, bone scans, and diagnostic pain injections.