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Pain Management Procedure - Epidural Steroid Treatment and Side Effects

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By soni2006


Caudal epidural steroid injection reference chart
Where a caudal epidural steroid injection is performed.
Where a caudal epidural steroid injection is performed.

Pain Management Procedure - Caudal Epidural Steroid Injection

This pain management procedure is used to relieve the lower back and radiating leg pain. Steroids may reduce swelling and inflammation caused by stenosis, radiculopathy, sciatica, and herniated discs.

Before performing caudal steroid injection, the pain management physician places a pillow underneath the stomach and back arch for comfort. The doctor uses a fluoroscope to find the small opening at the base of the sacrum.

How a caudal epidural spinal injection is performed?

Local anesthetic is used to numb the skin and tissue to the surface of the sacral hiatus. After the needle is carefully placed in the area, a contrast solution is used to help doctors to see the painful areas using the fluoroscope. Then, a mixture of anesthetic and antiinflammatory drugs is injected into the epidural space, infiltrating the painful area with medication. The needle is removed and a small bandage is used to cover the small area of the wound.

Most patients have relief after one or two caudal epidural steroid injections, but it may be necessary to repeat the procedure several times to get the maximum benefit from medication.

Common side effects may include allergic reaction, bacterial infection, bleeding in rare cases sometimes. Side effects of steroids are face, eyes, arms, and leg swelling, increase of sugar level in diabetic patients.

The patient should tell their doctors about pregnancy or if he/she takes blood-thinning medications.


Celiac plexus block is performed in this area.
Celiac plexus block is performed in this area.

Celiac Plexus Block

This pain management procedure is used to diagnose and relieve abdominal pain caused by cancer or pancreatitis. The injection blocks the nerves serving the abdomen. The intravenous anesthetic can be used to relax the patient.

How a celiac plexus block is performed?

Local anesthetic is used to numb the skin and tissues to the celiac plexus. A doctor uses a fluoroscope and contrast dye to confirm correct placement of the needle tip. Numbing medicine is injected around the nerves to block pain signals from reaching the brain.

The first shot could be a test. If pain relief occurs, permanent block could be used. Most patients have immediate pain relief after the injection.

Common side effects are bacterial infection, allergic reaction, bleeding in seldom cases. Steroids side effects are the face, arms, eyes, and leg swelling. Some diabetic patients experience increase in their sugar level.


Steroid injection into the Sacroiliac Joint

This procedure is done to eliminate pain caused by sacroiliac joint arthritis. Sacroiliac joint is a joint that connects the spine and pelvic bone. Steroid medication can reduce swelling and inflammation. During this procedure, the patient lies face down with a soft pillow under the stomach for better comfort and to help relax the spine.

How a sacroiliac joint injection is performed?

A local anesthetic is administered at the site of injection, which numbs all tissues to the sacroiliac joint. Then, a steroid-anesthetic mixture is injected into the painful area.

Possible side effects are comparable to the effects of a single injection: Patients may have allergic reactions, bacterial infection or bleeding that rarely happens.


Cervical facet joint injection
Cervical facet joint injection

How a facet joint injection is performed?

This injection is given to treat the facet joints, which cause back pain, neck pain, and inflammation. Each vertebra in the spine is connected with two facet joints. A local anesthetic numbs the skin and facet joint tissue.

Pain management physicians use fluoroscopy with contrast and resolution to confirm the correct placement of the needle tip and apply their knowledge of bony landmarks. A mixture of anesthetic and anti-inflammatory steroid medication is injected into the joint. Sometimes two or more injections may be needed. If the patient feels pain relief after the injection, this confirms that the facet joint is the source of the pain.

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kunika  says:
2 months ago

Good piece of work.

soni2006 profile image

soni2006  says:
2 months ago

Thanks a lot Kunika.

Veronica Allen profile image

Veronica Allen  says:
2 months ago

This sounds similar to an epidural a woman gets before giving birth except for the fact that these contain steroids and have to be given on a far more frequent basis than the one time injection given a laboring woman. Thanks for listing both the benefits and the side effects. Great info!

soni2006 profile image

soni2006  says:
2 months ago

Yes Veronica you got it right. I also received a local anesthesia injection similar to these epidural steroid injections when I underwent my kidney stone removal surgery in March 2005. I remember that kidney stone was really painful but after its removal with extracorporeal shock wave lithotripsy, I felt really really better. Thanks to RG Stone Research Institute located in New Delhi, India. They helped me a lot and took proper care of my stone.

sarovai profile image

sarovai  says:
2 months ago

New information for me and I got some knowledge about the steroid injections. Thank u soni2006.

soni2006 profile image

soni2006  says:
2 months ago

It's my pleasure sarovai. Thanks a lot for reading this hub in such a detail. Were you able to understand the information properly or it was tough?

rmcrayne profile image

rmcrayne  says:
2 months ago

Really good hub. We'll talk specifics by email.

soni2006 profile image

soni2006  says:
2 months ago

It's my pleasure friend. Waiting for your mail.

ethel smith profile image

ethel smith  says:
2 months ago

That was really interesting but too much information would make me more nervous :)

soni2006 profile image

soni2006  says:
2 months ago

I always like the fun-loving nature of yours Ethel. You are really humorous and that's a plus point to your personality.

Money Glitch profile image

Money Glitch  says:
2 months ago

Very interesting and informative hub, I love the detailed pictures and the pros and cons of having it done . I have heard of steroids being used for pain management, but I must admit I had never thought about it being injected into the spine. Thanks for sharing...

Jjustice profile image

Jjustice  says:
2 months ago

Soni, I have had this procedure preformed several times over the last few years for an L5-S1 herniated disk (7mm)and always have had good results. Recently, the last series I had when it flared up again has not produced success. The Dr. states that I may have reached the point where this will not work anymore. Unfortunately I am not a good candidate for suregery as the amount of time and metal needed to repair mine may cause complications and has a low percentage chance of success. Do you know of any other pain control methods that I can research?

soni2006 profile image

soni2006  says:
2 months ago

Sorry for the late response to your question Jjustice.

You asked, "Do you know of any other pain control methods that I can research?"

My answer: I think the best guide is your doctor. If he/she has not got any other options available, you can go ahead with searching for another prominent orthopedic spine surgery specialist in your area.

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