Caudal epidural spinal injection is used to provide relief for back pain caused by problems like sciatica, herniated disc, etc. Caudal epidural injection carries an anti-inflammatory steroid such as cortisone to the inner part of the spine where the more serious types of strain and injury can affect the disc and spinal joints, causing pressure or irritation of the nerves, or pain arising from the joints. In London, a Caudal epidural steroid injection procedure usually takes between 15 and 30 minutes.

Caudal epidural steroid injections are effective because it delivers the steroid as close as possible to the herniated disc or joint causing the pressure on your nerves, and thus providing instant and lasting pain relief.

Caudal epidural steroid injection procedures can help reduce inflammation and pain while allowing you to move more freely. Caudal epidural steroid injection contains a mixture of numbing solution (local anaesthetic) and corticosteroid (steroid).

The local anaesthetic will improve the pain immediately and the steroid in the solution will act on the inflammation around the covering (capsule) of the spines and control the pain in the long term. This improvement in the pain will help you move around better and mobilise your lower back.

Kenalog is a Steroid Injection used in Caudal Epidural Spine Injection | Spine Surgeon London | Mangattil Rajesh
Marcaine is a numbing solution used in Caudal Epidural Spine Injections | Spine Surgeon London | Mangattil Rajesh

Experienced spine surgeon Mr Rajesh understands that having any medical procedure, even one as simple and straightforward as an epidural steroid injection can cause anxiety in people. Do not worry! Mr Rajesh and his dedicated staff will be there to support and reassure you throughout!

If you are suffering from severe back pain in London, expert spine consultant & surgeon Mr Mangattil Rajesh offers Caudal epidural steroid injections along with comprehensive recovery plans to give you long-lasting relief from your Back and leg pain

If you are living in and around London, and are suffering from back pain, Call 07956 318 383 for a Consultation at one of London’s best Back pain clinic.

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Mangattil Rajesh, Consultant Spine Surgeon in London

Mr. Mangattil Rajesh

Consultant Spine Surgeon
Royal London Hospital

I am a Consultant Spine Surgeon at Royal London Hospital, London. My experience in treating your Back pain is from the extensive training in Spine Surgery from surgical rotations in London and from further 3 Spinal Fellowships at Manchester, North Tees, Royal London Hospital in the UK and further advanced training in France and USA in Minimally Invasive Surgery.

Treatment starts with Diagnosis

An accurate diagnosis is important to determine the source of your pain in the facet joints so that the facet joint injection can be administered in the right spot. Diagnosis for facet joint injections in London generally includes…

Diagnosis is the most important first step

There is no treatment without a diagnosis and there are several stages in the diagnosis of back pain.

  • History 
  • Clinical Examination 
  • Blood Investigation 
  • Imaging
  • Nerve Conduction Test

History: Back pain and leg pain is most commonly due to a Disc prolapse pressing on the spinal nerve as it comes out of the spinal canal. Mr Rajesh carefully listens to your story of how your back and leg pain started and progressed to the current state of pain. He will also be interested in the medications and the small adjustments that you may have tried to get relief from your back and leg pain (sciatica).

Spine Consultation | Mangattil Rajesh | Spine Surgeon London

This gives Mr Rajesh a very clear idea of the problem and he will then be able to decide on the nature of the examination and the investigation that is required to study the cause of your back pain and leg pain called sciatica.

Clinical Examination: As guided and directed by the story of your back and leg pain (sciatica pain), Mr Rajesh will decide on the type of examination that is required to assess the extent and severity of your back and leg pain. What he finds on the examination will give him a clue on the type of investigations that he needs to order for further information on your back and leg pain.

Blood Investigation: Blood investigations are usually not required as a routine in the diagnosis of low back and leg pain conditions. However if you have fever, loss of weight, loss of appetite or any other medical problems along with your back and leg pain, then blood investigations will be necessary.

Imaging: We all think that an X-ray will be very useful to look at the bones of our spine. However, these X-rays cannot show the soft tissues around the bones of the spine and the nerves that are trapped in our spine. Therefore, we need an MRI scan to look at the spinal nerves that are trapped in your spine much more clearly to have a good idea of the cause of your sciatica pain like a disc prolapse. 

CT scans can also be used but they carry a risk of high radiation. Whereas MRI scans do not have that risk of high radiation and they are very safe to be used in the diagnosis for the cause of your sciatica pain.

Special Tests – Nerve Conduction Test: Nerve conduction tests are occasionally used if there is difficulty in identifying the exact cause of your sciatica pain. Nerve conduction tests will only be recommended by Mr Rajesh to identify the cause of your trapped spinal nerve causing your back and leg pain. If all the other tests like MRI scan are normal, Nerve Conduction tests help with confirming the diagnosis.

As the premier Back pain specialist in London, Mr Mangattil Rajesh believes in utilising all the available latest technologies in his diagnoses and treatments. Once Mr Rajesh builds an accurate picture of his patient’s requirements, he implements preventative measures, plans and recommends the right time for your Caudal epidural steroid injection to help relieve you from Back pain.

Remember the more accurate the diagnosis, more successful will be the treatment for your Back and leg pain

Do you think a caudal epidural steroid injection can help relieve your back pain? Do not guess! Book a phone/online consultation today with expert back pain specialist, Mr Rajesh, in London at 07956 318 383

Get a diagnosis of your spine back pain from one of London’s best-reviewed back plain clinics to find out if you require a Caudal epidural steroid injection for your Back pain treatment.

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Why do you need Caudal epidural steroid injections?

Back pain and related symptoms can interfere with our lives while often attracting little sympathy. Caudal epidural steroid injection is recommended for control of your lower back pain. Inflammation caused by the wear and tear of your spine makes it susceptible to disc prolapse, herniation and nerve root problems. This is the main cause of low back pain in the middle-aged and elderly.

Back pain gets worse if you sit for very long – something that causes particular problems for people with office jobs. If you have injured your back while exercising or simply lifting a box from the ground you may believe it has nothing to do with the way you sit at your desk. Yet analysis shows us that the way we maintain the strength, balance and alignment of our musculoskeletal system, the more resistant our bodies are to such injuries.

As well as being one of the main reasons people take time off work, back pain can prevent you from:

  • Taking part in exercise or sport
  • Playing with your children and family
  • Driving 
  • Using computers for work or leisure.

Back pain along with leg pain is caused by deterioration or other damage to the spines that link together the bones in your back. Spondylolisthesis can also be a contributing factor in facet pain. The joint becomes inflamed and it is this inflammation that causes the pain. You are more likely to be affected if you are older but it can also affect young people. Some people sustain facet bone damage playing a sport, for example.

The caudal epidural steroid injection procedure is a simple outpatient procedure which approximately takes just around 20 minutes, including the time for a local anaesthetic to take effect.

Benefits of Caudal Epidural steroid injection for Back pain

An epidural steroid injection can be extremely beneficial during an acute episode of back and/or leg pain. Typically, if the initial injection is effective, up to 3 injections may be given in one year.

When administered in the lumbar space, caudal epidural steroid injections may have the following benefits:

Temporary or prolonged reduction of nerve pain and inflammation in the region of the spine that causes pain. Enhanced ability to perform daily life activities without the previous restrictions caused by pain.

Pain relief from these injections may help limit or eliminate the need for oral medications, some of which may have side effects when taken long-term. Epidural steroid spinal injections could reduce the need for invasive procedures.

Epidural steroid spine injections allow the body mechanisms time to heal the underlying condition. An epidural steroid injection may provide sufficient pain relief to allow a patient to progress with their physical therapy program.

Pain relief experienced from lumbar epidural steroid injections may help postpone surgery, and if physical therapy is effective, it may eliminate the need for surgical intervention

Do you think a caudal epidural steroid injection can give you the much-needed back pain relief you were looking for?

Book an appointment with expert Spine Consultant & Surgeon Mr Mangattil Rajesh to confirm if an Caudal Epidural steroid injection is absolutely necessary for your back pain!

Call today on 07956 318 383

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Caudal Epidural Injection

Here are some facts about the caudal epidural steroid injection procedure offered by London back pain specialist Mr Rajesh:

Caudal epidural steroid injection procedure is done as Day procedure. There is no need to stay overnight. You will need to come in starved for at least 6 hours and will be at the hospital for less than a day. You will be given a local or general anaesthetic by the anaesthetist so that you do not feel the pain of the procedure.


Spine injection procedure takes around 15 minutes and is very safe.


A thin hollow needle is inserted through the skin and muscles to the nerves in the spine. An X-ray is used to place the needle in the correct position. This system gives real-time X-ray images of the position of the needle in the spine on a monitor for the surgeon to view. When Consultant Spine Surgeon Mr Rajesh is satisfied with the position of the needle, the anaesthetic drug and corticosteroid are injected through the same needle inserted in the spine.


The Caudal epidural steroid injection procedure is painless but you may feel some pressure during the injection


The overall duration for the procedure will thus depend on the number of epidural steroid injections required to relieve pain. After the caudal epidural steroid injection procedure is done, you will be taken to the recovery room from the theatre and monitored for an hour. You will be able to leave the hospital on the same day once you are safe.

A Caudal epidural steroid injection can reduce pain for up to three months. However, London spine specialist Mr Rajesh considers Caudal epidural steroid injections as a crucial part of a holistic Back pain programme.

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You’re in safe hands!

Mr Mangattil Rajesh understands what it’s like to live with pain and how it can be exhausting, both emotionally and physically. He is personable and approachable and believes in empowering his patients to live a pain-free life. As an experienced Spine surgeon & Consultant in London, Mr Rajesh’s approach is to help his patients with effective but Minimally invasive treatments.

Cost of Caudal epidural injections in London

Depending on the underlying causes of your back and leg pain, Spine Consultant & Surgeon in London, Mr Rajesh, will advise you on the best course of treatment for your sciatica pain and help ease your leg pain completely. Specialist Spine Consultant & Surgeon Mr Rajesh offers affordable, competitive packages for Back pain treatment in London. Mr Rajesh accepts all Health Insurances for Back pain treatment in London.

Caudal epidural injection procedure with Mr Rajesh offers you the ability to avoid long waiting lists or expensive insurance premiums and access treatment quickly and easily in London.

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Get a consultation for your Back and leg pain treatment in London at your convenience! Mr Rajesh now offers phone and online consultation along with walk-in consultations. Choose your pick, Book an appointment for your Caudal Epidural steroid injection procedure in London. Start your journey towards a pain-free life!

Mr Rajesh is committed to providing the highest quality of care throughout his patient’s back pain treatment in London. For Caudal Epidural steroid injections in London, Mr Rajesh offers a full range of services, from initial assessment and diagnosis to individualised treatment and rehabilitation plans. Book an appointment with Spine specialist Mr Rajesh at 07956 318 383 and get customised individual assessment for your back and leg pain!

After Caudal epidural steroid injection


Following the Caudal epidural steroid injection procedure, Spine surgeon Mr Rajesh’s team will monitor your recovery. You will be able to go home when you are up and about and have passed urine. However, a friend or family member should escort you home.

Once the Caudal epidural steroid injection procedure is done, you may feel an immediate reduction or complete relief of your Back and leg pain. Because of the local anaesthetic, it may take several hours before the feeling comes back into the treated spine areas. 

You should be able to walk immediately after the procedure, although some people have some tingling or numbness for a few hours.

London Back pain specialist Mr Rajesh will give you exercises to improve your strength, spinal mobility, and stability. Mr Rajesh and his team are always available for support and guidance if you have any problems or concerns at any point during your recovery.

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What our Clients Say

Mr Rajesh is an experienced Spine consultant & Surgeon in London. He is very personable and approachable. Back pain specialist & Surgeon Mr Rajesh has the care and wellbeing of his patients at the heart of everything he does. You can read of some of the London back pain specialist reviews for Mr Rajesh

Frequently Asked Questions

1. How long do the effects of Caudal epidural steroid injections last?

Caudal epidural steroid injections have an immediate effect of pain relief from the local anaesthetic which wears off over a few hours. The steroid called cortisone starts to work in about 3 to 7 days and it can last up to a few months. More injections may be required for longer-lasting pain relief. Most specialists would wait for at least six months before repeating the injection.

2. Are Caudal epidural steroid injections painful?

Caudal epidural steroid injections are virtually painless since the procedure is done under local anaesthetics. When the local anaesthetic wears off, you may experience some discomfort where the needles were placed. Although pain relief with the Caudal epidural steroid injections generally occurs within 3 – 5 days, some patients experience improvement & pain relief right after the injection!

3. How many Caudal epidural steroid injections can you have?

Most experts recommend not more than 3 Caudal epidural steroid injections over 12 months. There are concerns about the adverse side effects of repeated steroid injections on your spinal cord, nervous system function and your metabolism. A Spine specialist would check & analyse for persisting symptoms before repeating the caudal epidural steroid injection.

4. What is the recovery time for Caudal epidural steroid injections?

You are advised to take the next day off work as you had intravenous sedation. You can return to normal life with gentle activity right after, and you can return to an active lifestyle within 3 – 5 days. If your back pain persists or is worse, you may need a few days off work. Usually, it can take several weeks before you feel the full benefit of the Caudal epidural steroid injection. There are no limitations for work if your pain settles after a day.

5. What are the risks and complications involved in Caudal epidural steroid injections?

Risks and complications are rare with epidural steroid injections. However, like with any treatment procedure, some of the common risks with epidural steroid injections are: 

  1. Infection: This is rare but there is an increased risk in skin conditions like psoriasis or eczema. The rate is less than 1 in 1000 injections
  2. Bleeding: People who take medications to ‘thin their blood’ like warfarin, rivaroxaban or clopidogrel will be advised to stop these medications at least a week in advance of the procedure for safety.
  3. Steroid facial flushing: A temporary side effect with flushing of the face and chest, with warmth and an increase in temperature for several days. Settles down very quickly.
  4. Anxiety or vasovagal: Caused due to the stress of the procedure and is not life-threatening. 1 in 100 patients do have such episodes and it settles very quickly.
  5. Menstrual changes.
  6. Water retention.

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