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Injections of local anaesthaetic and steroid can give significant and in some cases prolonged pain relief. There are 2 main groups Caudal Epidural injections and focal injections.
Why Caudal Epidural?
This is given for pain due to slipped or prolapsed disc or wear and tear in the spine (spondylosis), or spinal stenosis. It is not the same as the epidural given in childbirth. It is injected at the bottom of the spinal column in a gap in the sacrum called the sacral hiatus.
The philosophy of a caudal epidural is to wash local anaesthaetic (bupivacaine) and strong steroids (Depomedrone, Adcortyl or Kenalog) over the end of the spinal cord. In theory this washes away any inflammatory particles away from affected nerve roots in the sacral and lumbar region. The steroid then calms down inflammation. Much of the pain from prolapsed discs is thought to be due to inflammatory chemicals created by the body.
Sometimes a dye is used to confirm the injection is in the right place.
Pros
These injections can give prolonged pain relief and can avoid the need for an operation. A caudal epidural is relatively risk free. It is done as a day case and can be done with a small amount of sedation if you are concerned about needles.
Cons
The pain relief may be only temporary. It can give you numb legs for a short period of time so someone else has to drive you home. Some patients can have allergies to components of the dye. You must tell your doctor about any allergies. There is a very small risk of infection. If you develop increasing pain and redness around your injection site you must tell your doctor immediately.
Why Caudal Epidural?
This is given for pain due to slipped or prolapsed disc or wear and tear in the spine (spondylosis), or spinal stenosis. It is not the same as the epidural given in childbirth. It is injected at the bottom of the spinal column in a gap in the sacrum called the sacral hiatus.
The philosophy of a caudal epidural is to wash local anaesthaetic (bupivacaine) and strong steroids (Depomedrone, Adcortyl or Kenalog) over the end of the spinal cord. In theory this washes away any inflammatory particles away from affected nerve roots in the sacral and lumbar region. The steroid then calms down inflammation. Much of the pain from prolapsed discs is thought to be due to inflammatory chemicals created by the body.
Sometimes a dye is used to confirm the injection is in the right place.
Pros
These injections can give prolonged pain relief and can avoid the need for an operation. A caudal epidural is relatively risk free. It is done as a day case and can be done with a small amount of sedation if you are concerned about needles.
Cons
The pain relief may be only temporary. It can give you numb legs for a short period of time so someone else has to drive you home. Some patients can have allergies to components of the dye. You must tell your doctor about any allergies. There is a very small risk of infection. If you develop increasing pain and redness around your injection site you must tell your doctor immediately.
