Caudal Epidural Injection

What is it and why might I need it?

A caudal epidural injection is an injection into the spine to reduce pain and inflammation. In very painful conditions, the combination of a local anaesthetic (which reduces the discomfort of the procedure) and steroid medication (which reduces inflammation) helps speed up recovery so that you can return to your normal everyday activities. It may be given along with an epidural injection.

It can be an alternative to having surgery in conditions where using very strong painkillers have not improved your symptoms and is more commonly used in conditions where pain is coming from the small joints at the back of the spine in the neck and lower back.

What does it involve?

Using an X-ray machine to guide the needle, the procedure involves first injecting a small amount of iodine into the very base of the spine so that it shows up clearly. Once the needle is in the correct position, a mixture of local anaesthetic and steroid medicine is injected into the small joints at the back of the spine using the X-ray machine for accuracy. The number of joints you will have injected depends on which ones are causing pain. Usually between two and eight joints will be injected.

Usually done as a day case under a short sedative anaesthetic (you will be sleepy but not fully asleep) or a light general anesthetic, the procedure usually involves being in hospital for several hours. If there is any chance you may be pregnant, please let the specialist know in advance as you should not have this treatment during the first three onths of pregnancy.

Is it painful?

You may experience mild discomfort but the anaesthetic should ensure that this is minimal. You may have a little pain afterwards, but this usually settles quickly with over rest and painkillers.

What are the risks?

The main risk is that the injection may not work for everyone. However, in around 75 per cent of cases it gives a worthwhile benefit. There is a very small risk of infection (between 1 in 1000 to 1 in 10,000).

How long does it take to recover?

It’s a good idea to avoid too much exercise or going on long journeys for a few days after the procedure; however, you should be able to carry on with your everyday activities as usual. You may be offered physiotherapy which usually starts around four or five days after the procedure. It usually takes around two weeks to feel a significant benefit from the injections and in some cases it can take up to a month.

Will I need to have it more than once?

Usually, one injection is enough to relieve symptoms from a few weeks to more than a year; however, occasionally you may need to have a second or even third injection.

What about follow-up appointments?

If your symptoms improve, you will need to make a follow-up appointment around four weeks after the injection; however, if the injection doesn’t help, it’s a good idea to make a follow-up appointment two weeks afterwards.

Important: This information is only a guideline to help you understand your treatment and what to expect. Everyone is different and your rehabilitation may be quicker or slower than other people’s. Please contact us for advice if you’re worried about any aspect of your health or recovery.