Caudal Epidural Steroid Injection & Nerve Block in Washington DC, Baltimore, Maryland, Virginia | MedStar Health
Illustration of a man with lower back pain

Caudal epidural steroid injection and nerve blocks are steroid injections that are given in the coccyx, also known as the tailbone or caudal, region to treat chronic lower back pain and chronic pain in the legs. Although both injections aim to relieve pain using a steroid solution, each one is administered differently.

An epidural is injected into the epidural space, the area that surrounds the dura san, the protective tube of the nerve roots. A caudal nerve block is injected into a specific nerve root in the tailbone region.

Our caudal epidural steroid injection and nerve block for pain relief treatment can be found throughout the Washington DC, Baltimore, Maryland, and Virginia areas. Book an appointment with a specialist today! 

Why are caudal epidural steroid injections performed?

Our spinal cords house numerous nerves that run down the back, and out to the rest of the body. The lower portion of the spinal cord contains the nerves that extend out through the legs and to the feet. When one of these nerves is irritated and becomes inflamed, it can cause pain in the lower back and legs.

Inflammation of the spinal nerves can be caused by:

Caudal epidural and caudal nerve block help to reduce inflammation and relieve pain in the lower back and legs.

What to expect during a epidural steroid injection procedure

Caudal epidural injecton and nerve block injections are outpatient procedures, meaning that patients can go home soon after the treatment. The procedure generally takes between 10 and 20 minutes to complete. The pain management specialist uses real-time X-ray imaging to ensure that the medication is delivered to the correct area.

Before the procedure, patients are asked to lie face down on an X-ray table with a pillow underneath the abdomen. The pain specialist cleans and then numbs the area of the lower back located just above the buttocks with a topical anesthetic before inserting a needle and injecting contrast dye into the caudal area. The contrast dye is visible in the X-ray images and allows the pain specialist to see exactly where the dye is being delivered. Finally, the medication is injected into the caudal space.

Risks factors for steroid injections

The risks are low, but may include:

  • Bleeding at the site of the injection
  • Infection at the site of injection
  • Headache


Caudal epidural injection and nerve block injections provide pain relief without the need for a surgical procedure. Additionally, caudal nerve block injections can help doctors identify the precise cause of pain to make a diagnosis. In order to do this, a local anesthetic is injected onto a specific nerve root. The patient is then asked to describe any change in pain symptoms. When the patient experiences a decrease in pain, this indicates that the nerve causing the patient’s symptoms has been located.

How to prepare

When scheduling your procedure, patients should inform the pain specialist about any current medications. It may be necessary to discontinue certain medications, like blood thinners, for some time before the procedure to reduce the risk of bleeding or other complications.

Post treatment care

Typically, patients are advised to refrain from strenuous activities and driving for at least 24 hours after the procedure. Most patients will experience pain relief in approximately two to three days after the injection. It is not uncommon to have soreness in the area for a few days following the procedure.

How long does a caudal steroid injection last?

The effects of a caudal epidural or nerve block can last up to several months, but they are not permanent. In order to experience long-term pain relief, periodic injections are needed.


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Convenient locations in Washington, DC, Baltimore, Maryland, and Virginia.

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MedStar Washington Hospital Center

110 Irving St. NW
Washington, DC 20010

MedStar Health: Medical Center at Lafayette Centre

1133 21st St., NW
Building 2
Washington, DC, 20036

MedStar Health: Medical Center at Brandywine

13950 Brandywine Rd.
Brandywine, MD 20613