Caudal Epidural Steroid Injection in Castle Rock
What is a Caudal Epidural Steroid Injection?
A caudal epidural steroid injection (CESI) is a minimally invasive procedure designed to relieve pain caused by inflammation or irritation of spinal nerves. This treatment involves injecting a steroid medication and a local anesthetic into the caudal epidural space, which is located at the base of the spine near the tailbone. CESI is particularly effective for patients with widespread lower back and leg pain due to nerve inflammation.
How does a Caudal Epidural Steroid Injection Work?
The injected steroid reduces inflammation around the affected nerves, alleviating pain and discomfort. The local anesthetic provides temporary relief while the steroid takes effect over the following days. By decreasing inflammation, the injection can improve mobility and function, allowing patients to participate in physical therapy and other pain management strategies.
Because this injection spreads throughout the lower spine, it can provide broad relief for multiple irritated nerve roots.
What Conditions are Treated with a Caudal Epidural Steroid Injection?
CESI is commonly used to manage conditions such as:
Chronic lower back pain
Sciatica (lumbar radiculopathy)
Herniated or bulging discs
Spinal stenosis
Post-surgical nerve pain
Nerve root inflammation from arthritis or bone spurs
Failed back surgery syndrome
How Should I Prepare for a Caudal Epidural Steroid Injection?
Before your procedure, inform Dr. Carrera’s team about any medications you are taking, especially blood thinners and antibiotics. You may need to temporarily stop blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil, Aleve, meloxicam, and naproxen.
If you are receiving IV sedation, you may be advised to avoid eating or drinking for several hours before the injection. IV sedation is rarely needed for this procedure.
Arrange for someone to drive you home after the procedure, as you may experience temporary numbness or weakness in the affected area. Wear loose clothing to allow easy access to the injection site.
What Happens During a Caudal Epidural Steroid Injection?
Patient Positioning: You will lie on your stomach on a treatment table.
Local Anesthesia: A numbing agent may be applied to the skin to minimize discomfort.
Fluoroscopic Guidance: Using real-time X-ray (fluoroscopy), Dr. Carrera will carefully guide a thin needle into the caudal epidural space near the tailbone.
Contrast Dye Injection: A contrast dye is injected to ensure accurate placement of the medication.
Steroid Injection: A mixture of steroid medication and local anesthetic is injected into the caudal epidural space, allowing the medication to spread across multiple lower spinal levels.
Completion: The procedure typically takes 2-5 minutes.
How Painful is a Caudal Epidural Steroid Injection?
Most patients report mild to moderate discomfort during the procedure. The local anesthetic helps numb the area, but you may feel brief pressure as the medication is injected. When performed by Dr. Carrera, patients typically rate the pain between 1 and 4 out of 10.
Dr. Carrera uses the smallest needles possible, even smaller than those used for flu shots, to minimize discomfort.
What Should I do after a Caudal Epidural Steroid Injection?
Avoid strenuous activities for 24 hours following the procedure.
You may gradually resume normal activities as tolerated, following Dr. Carrera’s recommendations.
Avoid submerging the injection site underwater for two days.
Do not apply a heating pad or ice pack directly to the area for the first 48 hours.
Mild soreness or temporary numbness in the legs or lower back is common and typically resolves within a few days.
When Will My Pain Improve after a Caudal Epidural Steroid Injection?
Pain relief typically begins one day after the procedure, with full effects noticeable in one week. Some patients experience immediate pain relief due to the local anesthetic, though this is temporary.
How Long Does a Caudal Epidural Steroid Injection Provide Pain Relief?
The duration of pain relief varies among patients. Approximately 50–75% of patients experience at least a 50% reduction in pain lasting several months or longer. If sufficient pain relief is not achieved after two weeks, a repeat injection may be recommended, as the effects can be cumulative.
How Often can I Get a Caudal Epidural Steroid Injection?
You can usually repeat a caudal epidural steroid injection every three months, as long as you experience at least three months of at least 50% improvement in pain. It is recommended to limit steroid injections to five per year across your entire body to avoid potential steroid-related side effects.
Does Insurance cover Caudal Epidural Steroid Injections?
Most insurance plans, including Medicare, Medicaid, and commercial insurers, cover caudal epidural steroid injections if the patient meets certain medical criteria. These criteria typically include experiencing pain for at least six weeks and failing conservative treatments such as physical therapy, medications, and lifestyle modifications. Some insurance companies allow for injections sooner than six weeks.
Insurance providers often require prior authorization before approving the procedure.
Who can Perform a Caudal Epidural Steroid Injection Procedure?
Caudal epidural steroid injections should be performed by physicians with expertise in spinal procedures, typically interventional pain specialists or physical medicine and rehabilitation (PM&R) specialists.
Dr. Carrera is double-board certified in interventional pain medicine and PM&R, making him uniquely qualified to perform CESI with precision and safety.
Dr. Carrera performs these injections in an in-office procedure suite, which helps patients save significant costs compared to a surgery center. Additionally, he uses exceptionally small needles, even smaller than those used for flu shots, to maximize patient comfort.
While some offices can take up to six weeks to schedule a caudal epidural steroid injection, Dr. Carrera’s team can typically perform the procedure within 2 to 7 days of your initial visit, ensuring timely pain relief.
Should I get a Caudal Epidural Steroid Injection?
If you are experiencing chronic lower back pain, sciatica, or radiating leg pain, and are wondering if a caudal epidural steroid injection is the right treatment for you, a consultation with Dr. Carrera and his team can help determine your eligibility.
Patients in Castle Rock, Lone Tree, Highlands Ranch, Parker, Denver, and surrounding areas are encouraged to call the office at 720-455-3775 to schedule a visit and learn more.