You have been advised to have an epidural caudal injection. This is an injection of medicine around your spinal nerves. The medicine is a combination of local anesthetic and steroid medication. It may help by reducing the inflammation and swelling which may be the cause of your pain.
The injection will not stop all of your back and leg pain, but may help reduce it. It may reduce the pain down the leg. The effect is temporary, though some patients say it helped for a long time.
The procedure will be done at a surgery center. You should plan on about 45 – 60 minutes at the office after which your friend or family may drive you home.
- Stop taking the anti-inflammatory medication [Aspirin, Motrin, ibuprofen, Naprosyn, sulindac, Lodine, etc.] a few days before the injection.
- Don’t eat for about 6 hours before the procedure.
- Make sure the x-rays; MRI scans etc. are at the office or with you for the injection.
The injection: This will take only a few minutes. You will be lying down, and the skin around the buttock area will be cleansed. A combination of local anesthetic, saline, and cortisone medication will be injected. You may need to stay in the office until you are felt to be stable.
Alternative treatments: Other ways of managing the problem may vary from doing nothing at this time; to taking different treatment measures may be considered depending on your personal situation. Do not hesitate to discuss the reasons for your choice and the alternative treatments available. The potential risks and side effects of each treatment should also be considered.
After the injection – discharge instructions:
- Contact your doctor immediately if you experience severe symptoms which you did not expect including:
- High fever over 100 degrees
- Severe headache especially when standing
- Worsening of any weakness
- Loss of control of bowel or bladder function
- Drainage from the injection site
- Change in mental status (confusion, loss of consciousness etc.)
- Others severe troubling symptoms.
- You have received an injection of medication into your spine for relief of pain. You may feel soreness at the site of injection for a few days. Your original symptoms may even be slightly worse and for a day or two.
- You may experience “hot flashes” at night. You may also experience some water retention or “puffiness” of your hands or legs. If you have diabetes or glucose intolerance, your blood sugar may vary considerably for a few days and should therefore be monitored closely until it stabilizes.
- You may experience numbness around the area of your usual pain for several hours. Be very cautious about injury to the “numb” portion of your body. You may also experience weakness of your legs. Be very careful when walking until this feeling resolves.
- If you experience a headache with the injection rest with your head flat and drink lots of fluids.
- Rest today. Resume moderate activity and walking at home. Avoid long periods of sitting, heavy lifting, bending or any activity that causes you pain regardless of how well you feel. Gradually resume your normal activity, as you feel able to do so.
- Be aware that your legs may feel weaker today but this feeling will resolve. We suggest that a responsible adult be with you for the rest of the day and through the night for your safety.
- You may use ice for 30 minutes at a time every hour for the first day to relieve discomfort at your injection site. Place the ice on a towel over your skin. Tomorrow you may alternate heat and ice.
- Take your regular medication as prescribed.
- The injection should start to give you some noticeable reduction in your pain over the next 7-10 days. Discuss your changes if any with Dr.Rao at your next follow up visit.