What is a Sacral Epidural?

A sacral epidural, also known as a caudal block or caudal epidural, is a type of injection in which the needle is inserted into a space — known as the sacral gap — in the spinal column just above the tailbone. Epidurals are most commonly thought of as a form of pain relief for women who are in labor during childbirth, but they are also administered for other kinds of pain with a variety of causes. As with any epidural, a sacral epidural is useful because it allows the patient to remain conscious and aware while effectively controlling pain.

In all types of epidural, the needle is inserted into the epidural space between the bones of the spine and the dura, the membrane that covers the spine. Epidural injections may be given in multiple locations in the spine, including the cervical, thoracic, lumbar, and sacral regions, depending on the location of the pain and the specific needs of the patient. Fluoroscopic guidance, a form of X-ray used to view real-time movement inside the body of a patient, is sometimes used when giving an epidural to ensure accuracy and precision.

A sacral epidural can be used to deliver analgesics for temporary pain relief. It can be used for pregnant women in labor, people undergoing medical or surgical procedures, and people enduring intensive physical therapy. It is an effective form of pain relief for most patients.

Anti-inflammatory medications such as corticosteroids can also be given using a sacral epidural, usually for the treatment of chronic back pain as a result of conditions such as nerve damage, bone spurs, or herniated discs. In the treatment of chronic back pain, epidurals are used both as a diagnostic tool and to provide pain relief. If the injection of a temporary analgesic into a certain area works to reduce or eliminate pain, this area is more likely to be identified as the cause of the pain. Anti-inflammatory medications may then be injected into the identified area. A sacral epidural may be more likely to be administered for low back pain than for pain in other locations.

All forms of epidural can have side effects, and a sacral epidural is no different. Minor complications such as dizziness, nausea and headache can result from any epidural injection. More seriously, infections and abscesses that require additional treatment can occur in the epidural space as a result of the injection.

Epidural hematoma, the buildup of blood in the epidural space, is a rare but potentially fatal complication that can follow an epidural injection. Surgical intervention may be required to treat it. Epidurals are generally safe and effective for patients, however, and complications are rare when the injection is administered by a well-trained and capable physician.