Caudal Steroid Injection

This pain management procedure is used to relieve low back, radiating leg pain and coccydynia. The steroids can reduce the swelling and inflammation caused by stenosis, radiculopathy, sciatica and herniated discs.

During the caudal steroid injection a patient lays face down and a cushion is placed under the stomach to arch the back for comfort. A physician then uses fluoroscopy to find the small opening at the base of sacrum.

A local anesthetic is used to numb the skin and tissue down to the surface of sacral hiatus. After a needle is carefully placed in the area of 1-2 cm; a contrast solution is injected to help the physician see the painful areas under fluoroscopy. Then a mixture of anesthetic and anti-inflammatory medicine is injected into epidural space, bathing the painful area in the medication. The needle is then removed and a small bandage is placed to cover a tiny surface wound.

Most patients have significant relief after one or two caudal steroid injections but it may be necessary to repeat the procedure several times to get the full benefit of the medication.


Possible side effects could be compared with common injection side effects, i.e. allergic reaction, bacterial infection, or bleeding in seldom cases. Steroids side effects are facial, eye, arms, or legs swelling and elevated sugars for diabetic patients.

It is very important that the patient inform the physician about pregnancy or if he/she is taking blood thinning medication.