The caudal approach to the epidural space involves the use of a Tuohy needle, an intravenous catheter, or a hypodermic needle to puncture the sacrococcygeal membrane . Injecting local anaesthetic at this level can result in analgesia and/or anaesthesia of the perineum and groin areas. The caudal epidural technique is often used in infants and children undergoing surgery involving the groin, pelvis or lower extremities. In this population, caudal epidural analgesia is usually combined with general anaesthesia since most children do not tolerate surgery when regional anaesthesia is employed as the sole modality.
Steroids are used to fight inflammation and speed healing. For injuries, this treatment may be a good idea, but for most back pain scenarios, I always ask, where is the inflammation? As Dr. Sarno has pointed out time and time again, there is rarely evidence of any inflammatory process in the majority of chronic pain complaints. Even in cases where inflammation exists, steroids are not a very good option, since they are often completely ineffectual or only provide short term benefits, sometimes only due to the placebo effect.