Illustration of a man with lower back pain

Caudal epidural and caudal nerve block injections are steroid injections that are given in the coccyx (tailbone or caudal) region to treat chronic lower back pain and chronic pain in the legs. Although both injections aim to relieve pain using a steroid solution, each one is administered differently.

An epidural is injected into the epidural space, the area that surrounds the dura san, the protective tube of the nerve roots. A caudal nerve block is injected into a specific nerve root in the tailbone region.

Why Caudal Epidural and Caudal Nerve Blocks Are Performed

Our spinal cords house numerous nerves that run down the back, and out to the rest of the body. The lower portion of the spinal cord contains the nerves that extend out through the legs and to the feet. When one of these nerves is irritated and becomes inflamed, it can cause pain in the lower back and legs.

Inflammation of the spinal nerves can be caused by:

Caudal epidural and caudal nerve block help to reduce inflammation and relieve pain in the lower back and legs.

What to Expect During a Caudal Epidural and Caudal Nerve Block Procedure

Caudal epidural and nerve block injections are outpatient procedures, meaning that patients can go home soon after the treatment. The procedure generally takes between 10 and 20 minutes to complete. The pain management specialist uses real-time x-ray imaging to ensure that the medication is delivered to the correct area.

Before the procedure, patients are asked to lie face down on an x-ray table with a pillow underneath the abdomen. The pain specialist cleans and then numbs the area of the lower back located just above the buttocks with a topical anesthetic before inserting a needle and injecting contrast dye into the caudal area. The contrast dye is visible in the x-ray images and allows the pain specialist to see exactly where the dye is being delivered. Finally, the medication is injected into the caudal space.

Risks Associated with Caudal Epidural and Caudal Nerve Block

The risks associated with caudal epidural and nerve block are low, but may include:

  • Bleeding at the site of the injection
  • Infection at the site of injection
  • Headache

Benefits of Caudal Epidural and Caudal Nerve Block

Caudal epidural and nerve block injections provide pain relief without the need for a surgical procedure. Additionally, caudal nerve block injections can help doctors identify the precise cause of pain to make a diagnosis. In order to do this, a local anesthetic is injected onto a specific nerve root. The patient is then asked to describe any change in pain symptoms. When the patient experiences a decrease in pain, this indicates that the nerve causing the patient’s symptoms has been located.

How to Prepare for Caudal Epidural and Caudal Nerve Block

When scheduling a caudal epidural or caudal nerve block procedure, patients should inform the pain specialist about any current medications. It may be necessary to discontinue certain medications, like blood thinners, for some time before the procedure to reduce the risk of bleeding or other complications.

Post Caudal Epidural and Caudal Nerve Block Treatment

Typically, patients are advised to refrain from strenuous activities and driving for at least 24 hours after the procedure. Most patients will experience pain relief in approximately two to three days after the injection. It is not uncommon to have soreness in the area for a few days following the procedure.

The effects of a caudal epidural or nerve block can last up to several months, but they are not permanent. In order to experience long-term pain relief, periodic injections are needed.

Pain Management Locations

To find a pain management specialist,
call 202-877-3627

MedStar Washington Hospital Center

110 Irving Street, NW
Washington, DC 20010 

MedStar Health at Lafayette Centre
1133 21st St. NW
Washington, DC 20036

MedStar Health at Brandywine
13950 Brandywine Road
Suite 225
Brandywine, MD 20613