A caudal epidural steroid injection is a pain management procedure that is used to relieve low back and radiating leg pain. Dr Willis uses caudal epidural steroid injections as an important tool both diagnostically and therapeutically.

The membrane that covers the spinal cord and nerve roots in the spine is called the dura membrane and the space surrounding the dura is the epidural space. An epidural injection places anti-inflammatory medicine into the epidural space to decrease inflammation of the nerve roots, with the aim of reducing pain in the patient’s back or legs. The epidural injection may help the injury to heal by reducing inflammation. It may provide permanent relief or provide a period of pain relief for several months while the injury or cause of the pain is healing.

The decision to consider an epidural procedure is made after careful consideration by Dr Willis and the patient. Usually it is used because the patient has presented with severe back pain with radiating pain into the leg. Often there will be numbness or tingling, which implicates the nerve root.

There are many techniques used to perform an epidural and doctors often use different medications in their injections and at Clinica Tarraula Dr Willis uses between 100-120 mg. of Trigon Depot and 20 ml of local anaesthetic.

With 70% success after one injection, Dr Willis has found that few multiple procedures are required but invariably some patients will need a series of three injections. If more than one injection is needed they are usually done on a weekly basis. However, Dr Willis prefers to do one injection at a time and then see the patient the following week to evaluate the success of the procedure before deciding upon further treatment.

The epidural injections are extremely useful in alleviating back pain as well as diminishing acute leg pain. The swelling around the nerve root responds well to the steroid and allows rehabilitation and physical therapy to resume with a reduction in the pain. When utilized in the appropriate patient, they have had a tremendous benefit in the rehabilitation of low back pain. The injections allow for increased patient participation in therapy, which has resulted in a quicker recovery.

The success of the epidural steroid injection in relieving pain is due to the strength of the anti-inflammatory medication introduced into the epidural space. The risks associated are very slight and include infection or epidural abscess. There is occasionally a mild retrograde amnesic effect. For this reason, a full sterile technique is used when performing an epidural injection.

The epidural injection takes less than thirty minutes and the patient is monitored for changes in blood pressure and pulse. After returning home, the patient is advised to rest for the remainder of the day. They are allowed to return to work or full activity the following day, and are seen for follow-up in the clinic within a week.