Transforaminal Epidural Steroid Injection


About The Treatment

Your Desert Pain Specialists physician may recommend a caudal epidural steroid injection for patients suffering from chronic or persistent lower back or limb pain caused by conditions including herniated discs, sciatica, bone spurs, and other back problems. The caudal steroid injection process is a relatively simple outpatient procedure where a steroid-anesthetic medication is injected through the sacral region opening.

In performing the procedure, A Desert Pain Specialists nurse or physician will situate the patient either flat on their stomach with a pillow placed beneath the abdomen to elevate the sacral region of the lower spine. Some patients may be asked to lie on their side with their knees drawn in.

Once in position, the doctor will administer local anesthesia to the injection site, which is called the sacral hiatus located just above the opening at the base of the spine. This step helps numb the area to make the caudal steroid injection less painful for the patient.
After the region has become numb, the physician will carefully insert a needle through the sacral hiatus area and into caudal epidural space where the inflamed nerve roots are situated.

A contrast dye will be injected into the area, and the physician will utilize an x-ray device known as a fluoroscope to confirm that the needle placement is correct to address the affected area. Once the fluoroscopy ensures proper needle placement, the steroid-anesthetic medication in injected into the site. The irritated nerve roots within the sacrum are coated with the solution to alleviate the pain. This part of the procedure typically takes around five minutes to complete.


After The Treatment

After completing the procedure, the needle is removed and a bandage is applied to the insertion site. It is not advised to do any rigorous activities or drive for approximately 24 hours after a caudal steroid injection. However, normal activities may typically be resumed the next day.

Patients may experience relief within a half hour of the injection, but long-term relief is typically felt within 2-3 days after the procedure. Each caudal injection may last for several weeks to several months, and patients typically have varied results concerning the longevity of their pain relief. Physicians may recommend further treatments of this type in cases where the pain is chronic or recurrent.

There are very few risks associated with complications in this procedure. The most common risks include infection or bleeding at the site of the injection. On the rare occasions that the dura is punctured during the procedure, a slight headache may occur. Most of these effects will resolve within a few hours.