Article in Press Finds Caudal Epidural Steroid injection work for degenerative lumbar spinal stenosis. This condition is the bane of older individuals that can’t walk more than a 2-3 blocks without getting back – leg pain. The pain remits with rest – especially with sitting, which opens up the spinal canal. Surgery is an option; so is steroid injections given through the tailbone.
Skeletal Radiol. 2009 Dec 22. [Epub ahead of print]
Fluoroscopically guided caudal epidural steroid injection for management of degenerative lumbar spinal stenosis: short-term and long-term results.
Lee JW, Myung JS, Park KW, Yeom JS, Kim KJ, Kim HJ, Kang HS. abstract
Steroid epidural injections have taken hits from various articles that in my opinion do not distinguish well enough what they are treating and end up getting poor results. Fortunately, degenerative spinal stenosis is more clear cut. – You develop insufficent blood flow to the spine after walking and get pains down the legs. Sitting may be necessary for relief and subject may find self compelled to do so.
Differentiation is sometimes tough from your blocked leg blood vessels and I have seen cases that had both. Had one case that could bike for miles sitting, yet could not go to far standing.
Suggestive features:
discussed in recommendations here free article
- Pain on walking = pseudoclaudication – 1.2 times likely
- Changing symptoms on a downhill treadmill test – 3.1 times as likely
- Relief with sitting – poor to high prediction depending on study
- age over 65 – 2.5 times as likely
A previous article found no benefit from injections: