The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
As mentioned above, there may be more than one spinal structure causing your spine pain. Sometimes, there are multiple causes for your spine pain or radiculopathy. In this case, Dr. Lee may recommend alternative treatment options or steriod injections. For example, if your sciatica/leg pain or hand pain improves with epidural steroid injection but you still have low back pain or neck pain, you may benefit from facet joint injections. But, whatever the case, you will need further evaluation by Dr. Lee to decide on further treatment. Remember that there are multiple treatments available now for pain and just because one method yielded partial or no response DOES NOT necessarily mean you will “just have to live with the pain”!
It has been said that in many cases acute or chronic back pain can subside on it’s own within 3-6 months. This does not always mean that the source of the pain has healed but the inflammation in the nerves that causes pain sensations may have diminished. Epidurals are particularly effective in these cases as they enable a person to return to every-day activities; be that work, or exercise, much sooner that waiting months for pain to subside on its own. In cases where chronic pain does not subside within this period an epidural may have a short-term impact and may be a stepping stone to a more permanent treatment & long-term solution.