Understanding Your Options: Caudal vs. Transforaminal Epidural Injections

Nearly one quarter of Americans live with chronic pain. In many cases, pain that lasts for several months or longer involves the spine. That’s one reason back pain is a leading cause of missed work and disability. 

If ongoing pain in your back, neck, arms, or legs is disrupting your life and conservative measures haven’t done the trick, consider caudal or transforaminal epidural injections. 

Our expert team at Houston Pain Specialists, led by board-certified pain management specialist Hui Kang, MD, offers these epidurals to allow you to live more comfortably when other treatments haven’t sufficed.

Here’s a closer look at these injections, including key differences and how they can help.

How caudal and transforaminal epidural injections work

While not a first line of defense for pain, epidural injections provide a useful option when other options, such as oral medication and physical therapy, aren’t enough.

Both caudal and transforaminal epidural injections have thin medical needles that we use to place medication in your spine for targeted pain relief. They usually contain a corticosteroid, which gradually reduces inflammation, and a local anesthetic, such as lidocaine, for fast pain relief.

Caudal vs. transforaminal epidural injections

Caudal and transforaminal injections treat some of the same conditions, but they do so somewhat differently.

We place caudal epidural injections at the bottom of your tailbone. From there, the medication flows upward to your sacral and lower lumbar nerve roots. The injections work well for widespread pain conditions, such as:

• Degenerative disc disease
• Herniated discs
• Facet joint syndrome
• Radiculopathy 
• Spinal stenosis
• Spondylolisthesis
• Spinal arthritis

Transforaminal epidural injections place medication near a nerve’s exit point in your spinal canal. Because they’re so targeted, they may be ideal for:

• Bone spurs 
• Localized pain
• Disc herniation
• Sciatica
• Specific nerve root compression
• Spinal arthritis
• Spinal stenosis

Caudal injections are considered a bit safer than transforaminal injections, but they may not provide relief within the first few days. Because transforaminal injections are placed so close to the nerves, they carry a higher risk of long-term nerve irritation or damage. Even so, serious complications remain rare.

After your epidural steroid injection, you can expect to experience less pain within 2–5 days, though it may take several weeks to feel the full effect. While individual results vary, these benefits often last for weeks or months.

You may need to have epidural injections a few times a year for ongoing relief. Our team can determine a treatment plan based on your results.

To learn more about caudal vs. transforaminal epidural injections or to get started with personalized pain management, contact our Houston, Texas, office today to schedule an appointment.