Back pain is a very annoying thing, isn't it? Sometimes this pain goes down the legs. If you are also suffering from this problem, your doctor may have told you about a 'Caudal Epidural Steroid Injection'. You may have felt a little scared when you heard that name, "Oh, I don't think it's right to inject medicine into your back." But don't worry, today we will talk about this simply, in all the details.
What is Caudal Epidural Steroid Injection?
Simply put, this is a special injection of medicine that is given at the very bottom of your spine, just above the tailbone (coccyx). The word "caudal" means "tail side."
Imagine, the important nerves that control many things in our body run through our spinal cord. There is a small space around these nerves. In medical terms, we call this the epidural space . If for some reason these nerve roots become inflamed or compressed, severe pain can occur.
This is when we use this injection. What this injection does is inject an anti-inflammatory medicine into the epidural space, where the swollen, pinched nerves are. For this, we use a type of medicine called a steroid or corticosteroid.
Don't be afraid of getting an injection in the back. This is a safe, minimally invasive treatment in most cases. The most important thing is to have it done by a doctor who has good experience with this.
When is this vaccine needed?
It is most commonly used for pain caused by a pinched nerve in the back, a condition called sciatica . This pain travels from the back down the legs. There are several conditions that can cause this.
- Herniated Discs: Jelly-like pieces of material between the vertebrae protrude and press on nerves.
- Degenerative Disk Disease / Lumbar Spondylosis: The discs between the vertebrae wear down with age.
- Lumbar Spinal Stenosis: Nerve compression due to narrowing of the spinal canal through which the nerves travel.
- Spondylolisthesis: One vertebra slips forward over another.
- Facet Joint Syndrome: Disorders that occur in the small joints that connect the spine.
- Failed Back Surgery Syndrome: Persistent pain after back surgery.
There are several treatment options for each of these conditions. You should discuss with your doctor whether this vaccine is appropriate for your condition.
What should you do before getting vaccinated?
Before you schedule a day to receive this vaccine, your doctor will talk to you to make sure it is safe for you.
- Give a complete medical history: Be sure to tell us about any other medical conditions you have (such as diabetes, high blood pressure, glaucoma).
- Tell your doctor about all the medications you are taking: Be sure to tell your doctor about all the medications you are taking, including vitamins, supplements, and even traditional medicines. It is especially important to tell your doctor if you are taking blood thinners . You may be asked to stop taking them a few days before the vaccination.
- If you are pregnant or suspect you are pregnant, tell your doctor: The X-rays used during this treatment can be dangerous for pregnant women. So, inform your doctor about that as well.
- Do not drive: Another important thing is to have someone drive you home on the day of the vaccination, as you should not drive for 24 hours after the vaccination.
What happens during the injection?
This process usually takes about 15-30 minutes. Let's take a step-by-step look at how to do this.
| Steps | What is happening? |
|---|---|
| Preparation | You will be changed into a hospital gown and placed face down on an X-ray table. You may have a pillow under your stomach for comfort. |
| Cleaning | The lower back where the vaccine is injected is thoroughly cleaned with an antiseptic solution. |
| Numbing medicine | Before the main injection, a small injection (local anesthetic) is given to numb the skin in that area. So you won't feel much pain. |
| Confirming the route | The doctor uses a special X-ray machine (fluoroscopy) to see exactly where the needle is to be inserted. Sometimes a special liquid called contrast dye is injected to make the area more visible. |
| Main vaccination | Once the correct location is confirmed, a steroid injection is injected into the epidural space. You may feel a slight push at this point. The most important thing is to stay still during this time. |
| Finishing | Once the injection is complete, the needle is removed and a small plaster is applied to the site. |
After the vaccination is finished?
Since this is an outpatient treatment, you can go home the same day. However, once the injection is complete, you will be monitored for about 15-20 minutes before being sent home.
Go home and rest for 24 hours. Avoid strenuous activities, lifting weights, or driving. There may be some bruising or soreness at the injection site for a few days. Most people start to feel better within two to three days. However, for some people, this can take up to a week.
Are there side effects and risks?
As with any medical treatment, there are potential side effects and risks, but serious complications are rare.
| Status | Description |
|---|---|
| Commonly expected side effects | |
| Temporary increase in pain | The pain may feel a little worse for a day or two until the steroid starts to work. |
| Soreness/bruising at the injection site | This will go away in a few days. |
| For diabetics | Steroids can cause a temporary increase in blood sugar levels (hyperglycemia) for a few hours or days. |
| Rare Complications | |
| Infection | Germs entering the injection site. |
| Bleeding | Bleeding or blood clot (hematoma) formation around the spine. |
| Nerve damage | This happens very rarely. |
| Severe headache (Spinal Headache) | It can be caused by a small leak of spinal fluid. This occurs in less than 1% of cases. |
If you have these symptoms, see a doctor immediately!
If you experience any of these symptoms after you get home, call your doctor immediately, or go to the nearest hospital emergency room (ETU). This is very important.
- If you have a severe headache that gets worse when you stand up or sit down and is relieved when you lie down (this could be a symptom of a spinal headache).
- Fever (this may be a sign of an infection).
- If you feel numbness or weakness in your legs (this may be a sign of nerve damage).
- Inability to control urination or defecation (this is a very serious emergency).
Take-Home Message
- Caudal Epidural Steroid Injection is an effective and safe treatment for back and leg pain.
- This often only helps control the pain, not cure the disease completely. But the pain relief will help you to carry out your normal activities.
- Before treatment, be sure to tell your doctor about all your illnesses and all medications you take.
- Be aware of dangerous symptoms that may occur after treatment (fever, severe headache, numbness in the legs, loss of bowel and bladder control). If any of these occur, seek medical advice immediately.
- If you have any questions about this treatment, don't hesitate to ask your doctor.
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After the vaccination is finished?
Since this is an outpatient treatment, you can go home the same day. However, once the injection is complete, you will be monitored for about 15-20 minutes before being sent home.
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