Caudal Epidural Steroid Injection – Lower Back & Leg Pain Relief

Why Caudal Epidural Steroid Injections Are Used

Caudal injections are especially helpful when inflammation and nerve compression occur in the lower spine.
They can ease pain and improve movement for people with:

Sciatica or lumbar radiculopathy (nerve pain that travels down the leg)
Herniated or bulging discs
Lumbar spinal stenosis (learn more)
Post-surgical scar tissue that compresses nerves
Chronic lower back pain that has not improved with conservative care

By calming inflamed nerve roots and improving circulation in the epidural space, a caudal epidural injection can make daily activities easier and support physical therapy progress.

How the Procedure Works

Preparation and comfort
You’ll lie face down while the skin near your tailbone is cleaned and numbed with a local anesthetic.
Needle placement under guidance
Using fluoroscopy (real-time X-ray), the specialist guides a thin needle into the epidural space at the base of the spine.
A small amount of contrast dye confirms the correct position.
Injection of medication
A combination of long-acting steroid (to reduce inflammation) and local anesthetic (such as lidocaine or bupivacaine to interrupt pain signals) is injected.
In some cases, the procedure may include epidural lysis of adhesions (Racz procedure) to break up scar tissue that contributes to pain.

The process typically takes 20–30 minutes, and most patients go home the same day.

Recovery and Aftercare

Immediate pain relief from the anesthetic may last a few hours, while steroid benefits continue to build over several days.
Mild soreness can be treated with an ice pack and over-the-counter pain relievers (NSAIDs or acetaminophen).
Patients can return to normal activities within 24 hours, following their provider’s instructions.

Benefits of Caudal Epidural Steroid Injection

Reduces inflammation and nerve irritation in the lower spine
Relieves sciatica, leg pain, and chronic lower back pain
Limits the need for oral pain medications, including opioids
May delay or eliminate the need for surgery
Enables better participation in physical therapy and rehabilitation
Outpatient procedure with minimal downtime

Possible Risks and Side Effects

Caudal epidural injections are generally very safe.
Rare but potential risks include:

Temporary headache, dizziness, or flushing
Bleeding or infection at the injection site
Allergic reactions to medications or contrast dye
Nerve injury (very rare)
Short-term increase in blood sugar or weight gain from the steroid

Your physician will review your medical history and imaging results to ensure this treatment is appropriate.

Related Treatments and Next Steps

A caudal epidural steroid injection is one of several interventional pain procedures available.
Depending on your condition, your care plan may also include: