Procedure Description
A caudal epidural steroid injection is a minimally invasive procedure used to deliver anti-inflammatory medication (steroid) and local anesthetic into the epidural space at the base of the spine via the sacral hiatus (tailbone area). The goal is to reduce inflammation and swelling around irritated spinal nerves, which can relieve lower back and leg pain.
This approach is particularly useful when other epidural routes (transforaminal or interlaminar) are not ideal or if broad pain coverage across multiple levels is needed.
What It Treats
Caudal epidural injections are commonly used to treat:
Lumbar disc herniation
Degenerative disc disease
Lumbar spinal stenosis
Sciatica or radiculopathy (pain radiating down the leg)
Post-surgical back pain
Chronic low back pain with or without leg involvement
It is especially helpful when the pain is bilateral, diffuse, or affecting multiple levels in the lumbar spine.
How It Is Performed
You will lie on your stomach on a procedure table.
The skin over the sacral area is cleaned and sterilized.
Local anesthetic is used to numb the injection site near the sacral hiatus (just above the tailbone).
A thin needle is guided into the caudal epidural space using fluoroscopic (X-ray) guidance to ensure accurate placement.
A contrast dye may be injected to confirm proper spread.
A mixture of corticosteroid and local anesthetic is injected into the epidural space.
The needle is removed, and a small bandage is applied.
The procedure usually takes 10–20 minutes and is performed on an outpatient basis.
Pre-Procedure Instructions
Do not eat or drink for at least 6 hours prior if sedation is planned.
Continue routine medications, unless otherwise instructed. You may be asked to stop blood thinners a few days prior—consult your provider.
Inform your physician if you:
Have allergies to contrast dye, steroids, or local anesthetics
Are pregnant or suspect pregnancy
Have an active infection or recent illness
Arrange for a driver if sedation is used.
Wear loose, comfortable clothing.
What to Expect After the Procedure
Some patients experience immediate numbness or leg weakness, which resolves in a few hours.
Pain relief may occur within 24–72 hours, but full benefits can take up to a week.
Temporary soreness at the injection site is common.
Avoid strenuous activity or heavy lifting for 24 hours.
You may resume normal activities the following day unless directed otherwise.
The effects of the injection can last weeks to months, depending on the condition and individual response. A series of 2–3 injections may be recommended for optimal benefit.
Contact your provider if you experience:
Severe pain or new weakness
Fever or chills
Redness or swelling at the injection site
Loss of bowel or bladder control
Find Lasting Relief for Lower Back and Leg Pain
At Parkview Pain & Spine, we use precise image-guided caudal epidural injections to reduce nerve inflammation and help patients regain mobility with less pain. If you're suffering from sciatica, disc-related pain, or spinal stenosis, this safe and effective option may be right for you.
👉 Schedule your consultation today to see if a caudal epidural steroid injection is the right step in your pain relief journey.