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East Sussex Out Patient Services An Assessment and Treatment Service working with EHS, H&R and HWLH CCGs Ultrasound Guided Caudal Epidural Steroid Injection Reasons For Injection o Caudal epidural steroid injections treat pain in the lower back and/or legs o Pain comes from problems in the spine, the nerves traveling through the spine, or the lumbar discs that are between the spinal vertebra bodies. o Conservative measures such as ice, rest, anti-inflammatory medication, neuropathic medication, and physiotherapy are tried first. o A caudal epidural injection is used to relieve severe pain due to chronic back diseases and acute sciatica. o Sometimes these procedures result in less or no medication for your back pain. o The procedure can sometimes even help you to avoid surgery. An independent provider within the NHS family UK Registered Company Number 6010055 East Sussex Out-Patient Services Ltd, Chaseley Trust, South Cliff, Eastbourne, E.Sussex BN20 7JH www.esops.co.uk ,tel: +44 (0)1323 744387 Description of Procedure o Your injection is performed as an outpatient procedure. o Please arrive 15 minutes before your procedure. Our nursing staff will be happy to answer any questions. o You will be lying face down and your lower back will be cleaned with antiseptic solution and an ultrasound probe will identify the spot for your injection. o Local anesthetic numbs the skin and a needle will be used to enter the epidural space o The steroid will be injected into the epidural space, which is seen on the Ultrasound. o Some patients feel pressure in the back or down their legs when the medication is injected. These feelings soon pass. o A small Band-Aid will be applied to your back and you will be taken back to the waiting room area. o The Consultant or Nurse will review you and you will be able to go home as soon as you are ready which is usually 20 – 30 minutes after the procedure. An independent provider within the NHS family UK Registered Company Number 6010055 East Sussex Out-Patient Services Ltd, Chaseley Trust, South Cliff, Eastbourne, E.Sussex BN20 7JH www.esops.co.uk ,tel: +44 (0)1323 744387 Pre-procedure Instructions o Please make sure that you have someone to take you home. o Review all your medication with us before the procedure. o If you take medication that affect your ability to form a blood clot (anticoagulants, such as Warfarin) a specific plan should be in place – ask your Consultant. o All other medications should be taken as normal unless your GP tells you otherwise. Post-procedure Instructions o Take it easy on the day of the injection and return back to normal activity the following day. o Do not drive on the day of the procedure. Potential Side Effects and Risks o The injection site can be sore after the procedure o During first few days your pain may increase due to the injection, though this is uncommon. o Ice, heat, and gentle massage can help prevent and or treat pain o Typically pain relief from the steroids takes two to seven days to appear, occasionally the relief comes on earlier or later. o Very occasionally (most commonly postmenopausal women) have some short-lived facial flushing. o Rare risks (less than 1 in 100000) include allergic reaction, infection or spinal bleeding. An independent provider within the NHS family UK Registered Company Number 6010055 East Sussex Out-Patient Services Ltd, Chaseley Trust, South Cliff, Eastbourne, E.Sussex BN20 7JH www.esops.co.uk ,tel: +44 (0)1323 744387 Follow-up and Further Care o After the procedure you will be given instructions on how and when to follow up. We will write to your GP to inform him/her of the procedure being carried out. o If this is your first injection you may be offered two or three repeat injections over the next two to three months based on results. Contact details If you have any concerns after your procedure please give us a call on 01323 744 387 For any problems occurring out of hours please contact your GP surgery. An independent provider within the NHS family UK Registered Company Number 6010055 East Sussex Out-Patient Services Ltd, Chaseley Trust, South Cliff, Eastbourne, E.Sussex BN20 7JH www.esops.co.uk ,tel: +44 (0)1323 744387