What Is A Caudal Steroid Injection?

A caudal steroid injection is a low back treatment method that entails administering an anesthetic to alleviate or reduce pain along with a steroid to decrease inflammation. Chronic pain in the lower region of the back is one of the most commonly reported health problems among adults. In actuality, approximately 40-70% of adults tend to suffer from lower back pain and caudal steroid injections are particularly effective at alleviating this pain.

There is an ample amount of evidence that shows that caudal steroid injections are commonly administered for both chronic and acute pain. This treatment method is becoming increasingly popular due to the short procedure time and the rapid onset of long-lasting relief. For instance, many patients who have received this type of injection report feeling an immediate improvement in their symptoms after the procedure. Furthermore, most individuals are able to return to their normal daily routines shortly after the injection has been completed.

Clinical research also shows that more than 70% of patients who receive caudal steroid injections report dramatic improvements in their quality of life and mobility. In particular, a meta-analysis study reviewed clinical reports about the effectiveness and safety of caudal steroid injections, including data from the last ten years. The results from all of the reports that were reviewed strongly support the use of steroid injections for the management of back pain.



The mechanism by which steroid injections work is not completely clear, but it has been proposed that the combination of an anesthetic and an anti-inflammatory steroid causes a decrease in nerve damage-induced pain as well as inflammation. Steroids, however, appear to have additional useful properties that enable it to be especially effective. For example, in addition to reducing inflammation, steroids have demonstrated the ability to promote the stability of nerve membranes and hinder the conduction of ions. These two processes are associated with reduced pain sensations.

The mechanism that causes the effects of caudal steroid injections to be long-term is unclear as well. This information remains ambiguous mainly because, in some cases, the injections lead to long periods of pain relief, but in other cases they do not. Despite the differences that have been observed in terms of the length of pain relief, steroid injections have been shown to be safe. The procedure can also be repeated throughout a one-year period if the first injection was only minimally effective at providing pain relief.

How Are Caudal Steroid Injections Performed?

A brief description of the spinal region and where the medication is injected helps clarify the injection procedure. The spinal region includes a column of individual bones, called vertebrae, that encase and protect the spinal cord all the way from the base of the skull to the tailbone. A vast number of nerves extend out from the spinal cord to the rest of the body. The spinal cord is held in place by a strong membrane. Directly outside of the membrane is a region known as the epidural space, where nerve roots are located. This is the area in which steroids are injected if nerves become damaged or inflamed.

The injection of an anesthetic, such as Lidocaine as well as steroids directly to the nerves roots, results in the alleviation or dramatic reduction of pain. While the steroid targets inflammation, the anesthetic disrupts pain signal transmission, thereby reducing pain. The steroids are specifically injected into the areas where serious inflammation has been confirmed through imaging screenings in order to limit healthy nerve roots from the exposure to the medication.

A caudal steroid injection is a non-surgical procedure and, as a result, it can be quickly performed in an outpatient setting. Previous reports have indicated that patients who receive a caudal steroid injection typically experience immediate improvements or feel as if their pain has been completely alleviated after the injection. In addition, a study that evaluated the effectiveness of repeated steroid injections throughout a one-year time frame showed that repeating the procedure provides more long-term effects.

Caudal Steroid Injection Cerebrospinal Fluid

 

Conditions Treated With Caudal Steroid Injection

A caudal steroid injection is typically recommended for individuals suffering from low back pain that is the result of nerve damage. Conditions that usually cause nerves to become inflamed or damaged include:

Conclusion

A caudal steroid injection is a treatment method for nerve damage-induced pain. This treatment is nearly painless and can be performed quickly. The procedure is usually recommended when compressed or irritated nerve roots that are located in the epidural space of the spinal cord have been determined to be the cause of a patient’s pain. Nerves that extend into the lower back may also cause pain to radiate into the buttocks and down the legs.

The combination of an anesthetic and steroids appear to make this technique quite effective and most patients report rapid pain relief as well as the ability to return to work or their daily routines directly after undergoing the procedure.

At Wake Spine & Pain Specialists our goal is to relieve your pain and improve function to increase your quality of life.
Give us a call today at (919)-787-7246.

References

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  2. Boswell MV, Trescot AM, Datta S, et al. Interventional techniques: Evidence-based practice guidelines in the management of chronic spinal pain. American Society of Pain Physicians. Pain Physician. 2007;10(1):7-111.
  3. Cervera-Irimia J Tome-Bermejo F. Caudal epidural steroid injection in the treatment of chronic discogenic low back pain. Comparative, prospective and randomized study. Rev Esp Cir Ortop Traumatol. 2013;57(5):324-332.
  4. Friedman JH, Dighe G. Systematic review of caudal epidural injections in the management of chronic back pain. RI Med J. 2013;96(1):12-6.
  5. Manchikant L, Cash KA, McManus CD, Pampati V. Fluoroscopic caudal epidural injections in managing chronic axial low back pain without disc herniation, radiculitis, or facet joint pain. J Pain Res. 2012;5:381-90.
  6. Manchikanti L, Falco FJ, Pampati V, Cash KA, Benyamin RM, Hirsch JA. Cost utility analysis of caudal epidural injections in the treatment of lumbar disc herniation, axial or discogenic low back pain, central spinal stenosis, and post lumbar surgery syndrome. Pain Physician. 2013;16(3):E129-43.
  7. Murakibhavi VG, Khemka AG. Caudal epidural steroid injection: A randomized controlled trial. Evid Based Spine Care J. 2011;2(4):19-26.