Caudal Steroid Injection

What Is Caudal Steroid Injection?

We all have nerves which run from the spinal cord down your back and legs. Back and leg pain is often caused by your nerve roots being irritated and inflamed, due to damaged disc(s).

A Caudal Steroid Injection is steroid medication administered to the epidural space, in the lowest part. Inflamed spinal nerves can be easily managed by this medication, and the procedure should only take a few minutes to complete.


The sciatic nerve is the largest nerve in the body. When irritated, it causes the condition sciatica. Sciatica usually affects one side of the lower body. It’s diagnosed as a pain that radiates from the lower back and down the thigh and leg. The pain can be either sharp, dull, or both, and is usually accompanied by numb or tingling sensation.

What does the procedure look like?

The procedure requires little preparation and is done in the clinic at Portland Pain & Spine. The patient will assume a prone position, face down with a pillow under the abdomen, lifting the sacrum.

The physician administers or injects a local anesthetic, desensitizing and numbing the skin and tissue above a hole at the bottom of the sacrum. This is called the sacral hiatus. 

When the location has been desensitized and is numb to touch, the doctor inserts a needle into the sacral hiatus, through the caudal epidural area and makes the injection. The injection is done in the location of the open space in the sacrum, the location of the inflamed nerves.

The physician then inserts a contrast solution with the needle. Then utilizing a fluoroscope, a kind of x-ray equipment, the doctor ensures that the end of the needle is accurately placed within the epidural space.

Following a careful examination of the needle’s exact position, the physician administers a  steroid-anesthetic medication.  The medication bathes the inflamed nerve roots,  easing the patient’s pain.

When the procedure is complete, the doctor removes the needle and dresses the injection entrance.  The patient usually experiences considerable relief after one injection.  However, this varies case to case. Some patients may require multiple injections before experiencing any form of relief.

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We want to assure our patients that Portland Pain and Spine remains open and actively managing your pain. Medication management is given the highest priority. Our relocation across the hall in the Washington building is complete but requires office renovation before we can accommodate patient visits. Staffing shortages affected our ability to communicate last month, however, this was temporary. Dr. Balog has reached out to all patients but asks that if anyone has additional questions or concerns to contact him at
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Wishing you all a joyful holiday season.