Caudal Block (a steroid alternative)


  1. You already had the steroid epidurals and since the steroids did not help, you have been told that the next step is surgery;
  2. You have tried the steroid epidurals and they did not help as much or as long as you had hoped they would; and/or
  3. You have been recently advised to get the steroid epidurals and after hearing the risks and benefits, you are looking for other safer options.


Epidural injections, sometimes called nerve blocks or epidural blocks, can be delivered in 3 primary areas of the lower back:

  1. Interlaminar injection (targets a wide area of the lower back);
  2. Transforaminal injection (targets a specific nerve as well as side); or
  3. Caudal injection (targets the extreme lower lumbar and sacral areas).

NOTE: “epidural” is actually an anatomical space in the spinal area outside the “dura” (a thin, strong fibrous lining that surrounds the spinal cord and holds the spinal fluid around the spine).


A caudal block uses a Prolotherapy solution (e.g., concentrated dextrose) to attract cells (e.g., stem cells) via an inflammatory response to an area where tissue proliferation is needed. This process allows the body to heal itself through the activation of natural healing pathways and thus, repair damaged or injured tissue. A Steroid is the opposite of Prolotherapy in that it is used for its “anti-inflammatory” effect. Steroids also have many negative side-effects, including, but not limited to:

  • Weakening or softening of bone, cartilage, ligaments and tendons;
  • Elevated blood pressure;
  • Elevated blood sugars;
  • Difficulty sleeping;
  • Water retention;
  • etc.

NOTE: There can be injection site soreness or bruising with any injection.


The sooner you have your Caudal Block treatment with a Prolotherapy solution, the sooner you can feel better. Plus treating a pain condition in the early stages keeps the injury from becoming a chronic one. Temporary relief via steroids is not what patients should be seeking. Permanent healing and pain relief should be the goal. Steroid injections weaken and worsens damaged tissue.


A Caudal Block with Prolotherapy solutions bring increased blood flow and healing factors to the injured tissue back, sacral, and coccyx. Any neck, back or other joint, ligament or tendon injury can be treated effectively with Prolotherapy. Prolotherapy is a treatment option that helps many people in pain significantly or completely heal. Pain levels, activity of daily living, anxiety, depression, disability, etc. can be improved. Published scientific medical literature concludes that Prolotherapy solutions are significantly better than steroids for overall healing and improved function.


Patient is a 51-year-old female with a chronic recurrent history of low back pain. She injured her lower back in sports at age 32 and was then treated with physical therapy.  Patient currently presents with severe, progressive and activity limiting lower back pain of 3 weeks duration. She is otherwise healthy. Previous treatments of 3 prior similar flare-ups consisted of 6 weeks physical therapy and home exercises. The first major episode of severe low back pain was almost 3 years ago.  The past 2 episodes occurred within the last 10 months and she received a series of 3 lumbar steroid epidural injections for her pain and inflammation with each episode (e.g., 6 steroid epidural injections over 9-10 months). This was based on L4-5 and L5-S1 disc “protrusions” seen on MRI. Finally, she is recommended to have a surgical consult for spinal fusion.

The patient then presented to the Turtle Healing Band Clinic (“THBC”) for a consultation and second opinion. A detailed history and exam were completed. Past and current treatment recommendations, as well as alternative treatment options, were discussed with the patient. Patient was scheduled for a Caudal Block using a Prolotherapy solution.

Following her treatment at THBC, patient had a > 50% decrease of pain and improved function within one week after her first Prolotherapy treatment. Two weeks, later a second Caudal Block treatment was performed. Upon follow-up with the patient, she stated that her pain was 80-90% improved, she could perform normal activities of daily living, she was sleeping “wonderful” again, and she was completely off all pain and sleep medications.

This case is just one example where Caudal Block with Prolotherapy solutions were able to strengthen the spine and its supportive tissues and return the patient to an active and normal life. This is not pain management….This was a pain cure!