Corticosteroids, also referred to as glucocorticoids or steroids, are drugs that are similar to cortisol, a hormone which is naturally produced in the cortex (outer layer) of the adrenal gland. These drugs are not the same as anabolic steroids that are used by some athletes to bulk up. In the 1940s, corticosteroids produced what seemed to be miraculous relief of arthritis in patients who were given daily injections. Corticosteroids were thought to be “the cure.” As corticosteroids became more widely used, it was discovered that significant side effects developed, especially at high doses or during long-term use. At low doses or for short-term use, the side effects were less severe and less evident. Currently, corticosteroids are mainly prescribed short-term to reduce flares of arthritis symptoms, or at a low dose that can be maintained to reduce inflammation because other medications are producing unsatisfactory results. Higher doses are used when inflammation is uncontrolled and must be quickly brought under control.

How Do Corticosteroids Work?

Corticosteroids block substances or chemicals that trigger allergic reactions or inflammatory responses (e.g., prostaglandins). Corticosteroids also interfere with the function of white blood cells that destroy foreign bodies, an important immune-system function. It is the interference with white-cell function that increases risk of infection in patients taking corticosteroids.

How Are Corticosteroids Used?

Corticosteroids are used to control inflammation in types of arthritis that are characterized by joint inflammation or systemic inflammation. Among others, some of the inflammatory types of arthritis include:

• Rheumatoid arthritis

• Systemic lupus erythematosus

• Ankylosing spondylitis

• Scleroderma

• Dermatomyositis or polymyositis

• Polymyalgia rheumatica

• Vasculitis

How Are Corticosteroids Administered?

Corticosteroids used to treat arthritis can be administered four ways: Steroid pills can be taken orally; injectable forms of steroids can be given as intravenous or intramuscular injections; and topical creams or ointments which contain steroids can be applied to the skin.

Corticosteroids include:

• Deltasone (prednisone)

• Cortef (hydrocortisone)

• Cortone (cortisone)

• Medrol (methylprednisone)

• Prelone (prednisolone)

• Decadron (dexamethasone)

• Celestone (betamethasone)

• Entocort EC (budesonide)

• Kenalog (triamcinolone)

Oral prednisone is the most commonly prescribed synthetic corticosteroid to treat arthritis. Five milligrams (5 mg) of prednisone is equivalent to the body's daily production of cortisol. The other synthetic corticosteroids differ in potency and how long they stay in your system.