Caudal Epidural Steroid Injections for Initial Treatment of Chronic Low Back Pain
Dr. Zeeshan Tayeb practices Pain Medicine in Cincinnati, Ohio. Pain medicine is concerned with the prevention of pain, and the evaluation, treatment, and rehabilitation of patients experiencing pain. Pain medicine physicians use a broad-based approach to treat all pain disorders, ranging from pain as a symptom of disease... more
Chronic low back pain is common in pain management, and many injections require extensive workups, physical therapy, and imaging to get insurance approval. Caudal epidural steroid injections (Caudal ESI) are often our first line of attack against chronic low back pain. In order to prevent a delay in treatment and provide significant pain relief, this type of injection can be performed for many patients in the interim while navigating through all the red tape that many insurance companies require for other injections.
Caudal ESIs involve introducing a local anesthetic and steroid medication directly into the sacral epidural space in the tailbone in an attempt to reduce inflammation in the nerves causing pain in the low back, buttocks, hips, and thighs. This pain may be caused by sciatica, herniated discs, bone spurs, or other low back problems. For this type of injection, a patient can expect to lay flat on their stomach on the x-ray table. The skin on the lower back is numbed by a local anesthetic and then a mixture of anesthetic and steroid medication is injected. The procedure usually takes less than 15 minutes, and after some brief monitoring, the patient can go home and rest.
When a patient gets a caudal ESI, they can expect to feel pain relief for a few hours or even a few days just from the anesthetic. After that, most patients can expect long-term pain relief from the steroid medication that kicks in around day 2 or 3 (or up to a week in some cases) and this relief can typically last anywhere from a few weeks to a few months. Over time, and depending on the individual‘s treatment plan, some patients may even remain pain-free with continued treatment over time.
If you are experiencing chronic low back and feel that this could be the right treatment for you, then contact us today to set up a consult. For current patients, talk to the staff at your next follow up appointment!
The image above is an actual depiction of a caudal epidural steroid injection being performed in the sacrum (tailbone region) under x-ray guidance.
