Wessex Pain Clinic

Caudal Epidural

A caudal epidural is a procedure that delivers anti-inflammatory medication into the lower part of the spine, through a small opening near the tailbone. It is designed to help relieve lower back and leg pain caused by irritated or compressed nerves.

How the Procedure Works

The epidural space is a fat-filled area around the spinal cord where irritated nerves can cause pain. In a caudal epidural, the consultant accesses this space through the sacral hiatus, a small opening just above the coccyx (tailbone), allowing medication to spread upwards along the spinal canal.

The injection usually contains a corticosteroid and a local anaesthetic. Using X-ray (fluoroscopic) guidance, your consultant ensures that the medication is delivered precisely where it’s needed. This helps reduce inflammation and soothe irritated nerves that may be causing pain in the lower back, buttocks, or legs.

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What Conditions It Can Help With

Caudal epidurals are commonly used to treat:
Sciatica or leg pain from nerve irritation
Lumbar disc herniation or prolapse
Spinal stenosis (narrowing of the spinal canal)
Chronic lower back pain with nerve involvement
Post-surgical or post-injury inflammation in the lower spine
The procedure may also be used diagnostically to help identify the source of nerve-related pain.

Aimed Benefits

The purpose of the caudal epidural is to reduce inflammation and pain around the nerves in the lower back. Potential benefits include:
Relief from pain radiating down the legs (sciatica)
Improved function and mobility
Better tolerance for physiotherapy or activity
Clearer understanding of what’s contributing to your symptoms
Some people experience significant relief, while others may find the effects shorter-lived or less than hoped.

What to Expect

This is an outpatient procedure, usually taking 20–30 minutes. You will lie on your stomach while the area near your tailbone is cleaned and numbed. The injection is performed under X-ray guidance to ensure precision and safety.
Sedation is usually offered for this procedure. Most patients go home the same day and are advised to rest for the remainder of the day.

Risks and Considerations

All procedures carry some risks, which will be discussed in detail with you during your consultation. You will have the opportunity to ask questions, and formal consent will always be obtained before any procedure is carried out.

Combined Approach / Multidisciplinary Care

At Wessex Pain Clinic we find that the best results come from combining medical treatments with active rehabilitation. Procedures are often most effective when paired with physiotherapy, movement-based exercise, and — where appropriate — psychological support. This comprehensive approach addresses both the physical and emotional aspects of pain and supports longer-term improvement.

Key Points Summary

  • Consultant-performed injection into the lower spinal canal
  • Targets inflammation around spinal nerves in the lower back
  • Often used for sciatica and nerve-related leg pain
  • Outpatient procedure under X-ray guidance
  • Complements physiotherapy and rehabilitation programmes

Disclaimer

Results vary between individuals and cannot be guaranteed. Your consultant will discuss whether this procedure is appropriate for you.

At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.

Driving advice: You should not drive that day if receiving any sedation. Our procedures do vary on whether they are possible to drive home from yourself, please seek advice from your consultant about driving advice. If you are seeing us for an injection and planning on driving, please check with us beforehand about whether it will be possible to drive yourself home afterwards.

Wessex Pain Clinic provides consultant-led assessment and treatment for acute and chronic pain conditions. Our multidisciplinary team includes Consultant Pain Specialists, Physiotherapists and Psychologists, offering evidence-based interventions alongside rehabilitation and self-management support. We welcome patients from across Hampshire, Dorset, Wiltshire, Surrey and Sussex, including Winchester, Basingstoke, Southampton, Portsmouth, and Chichester – with both in-clinic appointments and remote consultations available across the wider Wessex region.