Although epidural steroid injections (also called epidural corticosteroid injections) may be helpful to confirm a diagnosis, they should be used primarily after a specific presumptive diagnosis has been established. Also, injections should not be used in isolation, but rather in conjunction with a program stressing muscle flexibility, strengthening, and functional restoration.
Epidural injections and intradiscal injections have been used in the treatment of non-radicular degenerative disc disease with limited success. Proper follow-up after injections to assess the patient's treatment response and ability to progress in the rehabilitation program is essential. A limited number of injections can be tried to reduce pain, but careful monitoring of the response is required prior to a second or third injection.
How often cortisone injections are given varies based on the reason for the injection. This is determined on a case-by-case basis by the health care practitioner. If a single cortisone injection is curative, then further injections are unnecessary. Sometimes, a series of injections might be necessary; for example, cortisone injections for a trigger finger may be given every three weeks, to a maximum of three times in one affected finger. In other instances, such as knee osteoarthritis, a second cortisone injection may be given approximately three months after the first injection, but the injections are not generally continued on a regular basis.
In patients with the adrenogenital syndrome , a single intramuscular injection of 40 mg every two weeks may be adequate. For maintenance of patients with rheumatoid arthritis , the weekly intramuscular dose will vary from 40 to 120 mg. The usual dosage for patients with dermatologic lesions benefited by systemic corticoid therapy is 40 to 120 mg of methylprednisolone acetate administered intramuscularly at weekly intervals for one to four weeks. In acute severe dermatitis due to poison ivy, relief may result within 8 to 12 hours following intramuscular administration of a single dose of 80 to 120 mg. In chronic contact dermatitis, repeated injections at 5 to 10 day intervals may be necessary. In seborrheic dermatitis, a weekly dose of 80 mg may be adequate to control the condition.