Synergy Health Partners

What is Caudal Epidural Steroid Injection?

Caudal Epidural Steroid Injection (Caudal ESI) is a minimally invasive procedure designed to relieve pain and inflammation in the lower back and legs by delivering medication into the epidural space of the spine’s caudal region (near the tailbone). This procedure can effectively alleviate pain caused by various spinal conditions by reducing inflammation around the spinal nerves.

Lumbar Epidural Steroid Injection (Lumbar ESI)

Why Might You Need Caudal Epidural Steroid Injection?

Caudal ESI may be recommended if you experience:

  • Herniated Discs: Pain from discs that have slipped or ruptured in the lower spine.
  • Spinal Stenosis: Narrowing of the spinal canal causing nerve compression and pain.
  • Sciatica: Radiating pain from the lower back down the legs due to nerve irritation.
  • Degenerative Disc Disease: Age-related changes in the discs causing chronic pain.
  • Spondylolisthesis: A condition where one vertebra slips forward over the one below it, causing pain.

What Are the Steps in a Caudal Epidural Steroid Injection Procedure?

Preoperative Preparation
  • Medical Evaluation: Comprehensive review of your medical history, symptoms, and previous treatments.
  • Diagnostic Imaging: MRI or CT scans to identify the source and extent of nerve inflammation.
  • Informed Consent: Detailed discussion of the procedure, potential benefits, and risks.
During the Procedure
  1. Patient Positioning: You will be comfortably positioned on your stomach to allow easy access to the caudal region of the spine.
  2. Local Anesthesia: The area around the injection site will be numbed to minimize discomfort.
  3. Guided Injection: Using imaging technology like fluoroscopy, the needle is precisely positioned in the caudal epidural space.
  4. Injection Process: The corticosteroid and anesthetic mixture is injected to reduce inflammation and pain.
Postoperative Care
  • Observation: Brief period of monitoring after the injection to ensure there are no immediate side effects.
  • Activity Guidelines: Recommendations on limiting activity for a short period to allow the medication to take effect.
  • Pain Relief: Pain relief can begin within a few days, although full benefits may take up to a week to be realized.
Caudal Epidural Steroid Injection (Caudal ESI)

Recovery and Rehabilitation

Postoperative Care
  • Immediate Effects: Many patients experience significant pain relief and improved mobility shortly after the injection.
  • Pain Monitoring: Keeping a diary of pain levels to track the effectiveness of the treatment.
  • Follow-Up Appointments: Scheduled to assess your response to the injection and plan any further treatments if necessary.

Potential Complications

While Caudal ESI is generally safe, potential complications can include:

  • Infection: Risk of infection at the injection site.
  • Bleeding: Minor bleeding or bruising may occur.
  • Nerve Damage: Rare but possible risk of temporary or permanent nerve damage.
  • Allergic Reaction: Rare but possible allergic reaction to the injected medication.

Benefits of Caudal Epidural Steroid Injection in Pain Management

  • Significant Pain Relief: Rapid reduction in lower back and leg pain levels.
  • Improved Mobility: Enhanced ability to move and perform daily activities.
  • Reduced Inflammation: Targeted treatment to decrease inflammation in the caudal region.
  • Enhanced Quality of Life: Improved overall well-being and ability to engage in physical and social activities.

Find a Pain Management Surgeon

Find a Location


For appointments contact
Scheduling: 855.750.5757

For billing questions
Billing: 586.439.6242

Fax: 734.542.0220


For appointments contact
Scheduling: 855.750.5757

For billing questions
Billing: 586.439.6242

Fax: 586.261.1961
Fax (Pain Management): 586.838.1603