Department of Pain Management
Why has an epidural been suggested as a way of helping with my pain?
- Epidurals can be useful in helping you to start to move more freely and engage in physiotherapy and positive lifestyle changes if you have certain types of leg and back pain.
What is an epidural injection?
- Caudal epidural injections are done at the bottom of your tailbone (sacrum).
- It involves injecting a mixture of local anaesthetic and a long acting steroid into the space around your spinal cord and nerves (the epidural space).
- We perform these in sterile manner and under x-ray guidance in Derriford Hospital.
How do epidural injections work?
- Epidurals provide some pain relief and possible reduction in inflammation for the nerves that go down your legs and around your lower back.
- Steroids are not licensed for use, into the epidural space. However medical evidence suggests that the treatment can be beneficial for people with leg pain, and although there is some risk, individual injections are considered acceptable.
How long will the pain relief last?
- There is potential for this injection to provide prolonged pain relief and we hope that it would allow you to do more gentle activity, physiotherapy and positive life style changes that will also help.
You must inform the Pain team if:
- You have had any form of infection during the 14 days before your procedure
- You are on drugs that thin the blood or suffer with a problem that means your blood doesn’t clot normally
What are the side effects of the treatment?
- It is possible to worsen your symptom with these injections
- Very occasionally temporary numbness in the legs and buttocks which will wear off.
- The numbness may affect your bladder; you may find it difficult to pass urine for a short period of time, after your epidural.
- Repeated injections with steroids potentially increase the risk of spinal fractures. They may also suppress your ability to fight infections, and increase the risk of stomach irritation and bleeding.
- Spinal infections or bleeding can occur in rare circumstances; these are potentially very serious.
What happens immediately after the injection?
- You will be asked to lie on your back, or affected side, for up to 45 minutes.
- Your blood pressure and pulse will be measured, as you may feel faint, normally due to anxiety.
Before you are discharged
- You will be helped to your feet, to check your walking ability. Occasionally the injection can make your legs
- feel numb but the strength in your legs should not be affected.