Caudal / Sacral Block

(This is the section that explains the detail of the operation or procedure above and should be read in conjunction with the section Your Back Operation).

A caudal/sacral block is performed for pain that is caused by inflammation and irritation in the spinal canal. The aim of the procedure is to reduce the inflammation inside the spinal canal. This will then bring about partial or complete (but usually temporary) relief of the pain, spasm and referred pain that this inflammation around the nerves can cause.

The reason why your specialist performs this procedure and not a more invasive procedure, is because he or she is trying to be as conservative as possible in treating your symptoms.

When undergoing this procedure, you will be lying on your stomach on bolsters or pillows. Your specialist will use an X-ray machine to guide the needle that is used to do the procedure with. The needle is placed directly into the sacral hiatus – this is at the bottom end of the spine – and a mixture of steroids and local anaesthetic is injected into the sacral hiatus (also called caudal hiatus). This procedure is performed with local anaesthetic and sometimes with sedation.

This procedure can also be performed on an out-patient basis under CT guidance by a radiologist.



This photo demonstrates the angle that the needle is inserted into the sacral hiatus. This is  the bony opening seen from the side, directly in front of the tip of the arrow. When undergoing this procedure, you will be lying on your stomach and your specialist will insert the needle quite close to, or into, the buttock skin fold, depending on your anatomy. 


Ward care

You may sometimes have a bit of discomfort directly after the procedure, but this will clear up very soon. You will be allowed to move around freely following your procedure.


This procedure is usually performed as a day procedure.


It is incredibly important to get a lot of rest and exercise following your procedure. It is frequently useful to supplement your treatment with physiotherapy and local treatment such as massage therapy and chiropractic treatment.


Routinely you will receive a date for your follow-up appointment with your specialist. This may vary from anything between two and six weeks, but you will be seen earlier if there are any complications. It is important to realise that you will have to protect your back for the rest of your life and apply good back habits (see the section Caring for your Spine). This procedure is part of conservative management, bear in mind that it may fail and further treatment including surgery may be required.



This website is a patient resource compiled from information from leading spinal surgeons practicing in South Africa and complements the My Spine – Lumbar and My Spine – Cervical information booklets that you can obtain directly from your spinal specialist. You will find information about spinal conditions and treatment on this website.

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My Spine – Lumbar and My Spine – Cervical information booklets are now directly available from your spinal specialist. All patients that are undergoing spinal surgery in South Africa should have access to these booklets. Please ask your specialist at your pre-operative visit about these booklets.