Caudal epidural for sciatica

A caudal epidural is an injection which is given at the base of the spine. You will usually have a local anaesthetic to numb the area first. Your consultant will then use the latest scanning technology or x-ray guidance to locate the precise area for the injection. They will give you a mixture of local anaesthetic to reduce pain straight away and a steroid to reduce inflammation. This is injected directly into the epidural space. An epidural injection usually takes 15 to 30 minutes.

In some cases, a nerve root injection may be given as an alternative, it contains the same type of mixture of local anaesthetic and steroid but is specifically targeted to be infiltrated around the nerve root. It is given for the same indications. Your consultant may do the injection himself or refer you to an interventional radiologist or pain specialist.

As with any procedure, there may be some risks and side effects involved. Your consultant will explain these to you and let you know how to prepare.

You will usually be able to go home on the same day as your epidural. It can take up to a month to feel the effects of the steroid. Your consultant will let you know about returning to your routine, including exercise. They may even recommend physiotherapy.

When a nerve in your spine is physically compressed it is called a 'trapped' or 'pinched' nerve. You may need back surgery to release it. A trapped nerve can occur in different areas of your back for several different reasons, causing you to experience pain usually in the arms or legs.

Surgery to release the ‘trapped’ or ‘pinched’ nerves can be done in the neck or lower back and in rare cases the mid-back (thoracic spine). This surgery is described as a ‘discectomy’ or ‘decompression’and may be performed with insertion of instrumentation to increase the rigidity of the spine.