Caudal Epidurals For Sciatica
Caudal Epidurals For Sciatica
Sciatica, where an intervertebral disc in the lower part of the back becomes inflamed, which can then cause pain to be felt in the lower back and within the leg as well, can be a painful condition for many patients. Sadly it can also be a condition that is very hard to treat, in the sense that it can be resistant to conservative (non-invasive) treatments and this can leave patients frustrated because there is no let up from the pain.
The disc in the back has usually become inflamed through age or degeneration, although trauma or injury can also be to blame. Because the pain is felt in the legs as well as the back it can feel confusing for some patients, however, the problem really is caused within the back. Because the disc is inflamed and ‘angry’ it then inflames the nerves within the locality. These nerves act as the transmitters between the leg and the brain, so when the brain receives the pain signals, it assumes that the pain is in the leg!
A caudal epidural is a very safe procedure that is used to effectively soothe and bathe the nerves in the lower part of the back and also soothes the inflamed disc. The epidural is actually an injection that contains local anaesthetic, usually combined with a steroid.
The site of the injection is at the ‘dura’ on the lower back, just near the spinal cord, which is where the name epidural derives from.
Following the caudal epidural patients usually feel much less pain and can then start to increase their activity levels as well as undertake physiotherapy, to ensure that the condition does not re-occur.
An epidurogram is slightly different from the caudal epidural in the sense that the epidurogram is more of a test, rather than a straightforward pain management procedure.
When the epidurogram is used, the injection involves a small amount of X-Ray opaque dye being administered, which will then show up under X-Ray. This procedure is very efficient at highlighting areas of scarring. Scarring may be responsible for generating some of the pain, but since it will not generally show up on an X-Ray, your pain consultant will use this procedure to get a fuller picture of what is happening within this area and how best the pain can be treated.
Limitations Of Caudal Epidurals
The procedure of a caudal epidural is extremely effective and safe, but patients who have an illness or condition that prevents their blood from clotting, will not be advised to have this procedure. Other patients who are on medication to stop the blood from clotting will be able to undergo a caudal epidural, but they will have to be advised as to when they should stop taking their medication prior to the procedure.
Patients with any infection within the bloodstream or an infection at the site where the injection will be made will also be unable to have an epidural.
However, these limitations are fairly rare and so it really is an effective procedure that can ensure a positive outcome for the vast majority of patients.