The spine has 3 major regions:  the cervical, thoracic, and lumbar spine.  Below the lumbar region are two other sections, the sacrum & coccyx bones which are within the pelvis.   It is the large irregular triangular shaped bone.  The spinal canal extends into the sacrum.  When this area becomes inflamed or irritated, it may cause persistent low back pain, which is increased with sitting.

It is an injection of an anti-inflammatory steroid medication and local anesthetic deposited into the epidural space in the caudal region.  The steroid shrinks swelling around the nerve roots and the local anesthetic numbs the inflamed areas and relaxes the muscles around the epidural space.  To ensure proper placement of the medication, the procedure is performed under x-ray (fluoroscopy)

To treat low back and leg pain that may be due to inflammation of the vertebral disc and/or nerves.  However, it will not correct the medical problem causing the inflammation but may improve the level of pain you are experiencing.  It is not unusual to need more than one injection to obtain long term benefit.  These injections are done in a series of three, usually a month apart if needed.

Some risks, although remote include:  bleeding, infection, nerve injury, and allergic reaction to the medication(s).  Diabetics may have short-term elevation of blood sugars.  People prone to fluid retention may have increased fluid retention for 1-2 weeks.

During the injection, your low back/leg pain will be increased temporarily.  Immediately after the injection, you may feel your legs slightly heavier and they may be numb, which may last 1-2 hours.  You may get 4-6 hours of back pain relief immediately after the injection, however your pain will return and you may have more pain than usual for 5-6 days afterwards.

Upon registering at, Southwest Ohio Pain Center we will begin your procedure.  An IV will be started and you may be given medication for relaxation if you so desire. Your low back will be cleansed with an anti-septic solution and numbed with anesthetic.  This is felt as pressure, however you may also experience some increased discomfort.  Additional anesthetic will be used if this occurs. The procedure takes about 15-30 minutes.  A bandage will be applied at the needle insertion site, which may be removed the next morning.  You will be discharged when the physician authorizes and you are stable.

Relief varies from one person to the next. The only way to know if it will work for you is to have it performed.  The steroid may take several days to work and peaks in about 2 weeks.  Therefore, it may be several weeks before you feel a change in your pain.  You may apply ice to the affected area for 20 minutes every 2 hours to decrease local tenderness.  After the first day, you can perform activities as before and return to work.

You may NOT drive for the remainder of the day after your procedure.  No heat is to be used on the injection area for the remainder of the day.  No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.

If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.


♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.

♦ Have a responsible person to take you home.

♦ Arrive at the requested procedure time.  Please do not be late or your procedure may be cancelled. 


♦ Do not take ANY of the following 5 days before your procedure:  Coumadin

♦ Do not take ANY of the following 7 days before your procedure:  Plavix

♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection.  Do not stop the drug by yourself.

♦ Eat or drink 6 hours before the procedure.


  • You have an active infection, flu, cold, fever, or very high blood pressure.
  • You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.

Call the office at (513) 860-1039 for procedure related questions.