A Caudal Epidural Steroid Injection is a treatment for pain caused by inflamed and irritated spinal nerves. It targets the bottom part of the spine near the sacrum and coccyx (tailbone). Medication is put into the fatty cushion layer that surrounds the spinal nerve roots and lines the spinal canal. X-ray dye is injected to be sure the needle is positioned correctly for the area to be treated. Medications injected include a steroid (long-acting cortisone type medication) and a local anesthetic. The actions of these medications are to reduce pain, inflammation and swelling. The local anesthetic may provide immediate, but brief relief. The steroid can take anywhere from a few days to a week to start working, and is intended to provide extended relief. A second or third injection may be needed to obtain maximum benefit if symptoms are improving, but not fully resolved after one treatment. Physical therapy and/or other conservative treatments may also be recommended. If a repeat injection is needed, it may be done after two to three weeks.
