Corticosteroids are man-made drugs that closely resemble cortisol, a hormone that your adrenal glands produce naturally. Corticosteroids are often referred to by the shortened term “steroids.” Corticosteroids are different from the male hormone-related steroid compounds that some athletes abuse.
Some corticosteroid medicines include cortisone, prednisone, and methylprednisolone. Prednisone is the most commonly used type of steroid to treat certain rheumatologic diseases.
Steroid medications are available in several forms that vary in how easily they dissolve or how long they stay in the body.
Steroids might be given locally, to the precise place where a problem exists, or systemically, which means throughout the “system” or body.
Examples of local steroid treatments include joint injections, eye drops, ear drops, and skin creams. Systemic steroid treatments include oral medicines (given by mouth) or medicine that is delivered directly into a vein (intravenously or IV) or muscle (intramuscularly). Systemic steroids circulate through the bloodstream to various body sites.
When possible, local steroid treatments are prescribed instead of systemic steroids to reduce the risk of side effects.
Steroids work by decreasing inflammation and reducing the activity of the immune system. Inflammation is a process in which the body’s white blood cells and chemicals can protect against infection and foreign substances such as bacteria and viruses. In certain diseases, however, the body’s defense system (immune system) doesn’t function properly. This might cause inflammation to work against the body’s tissues and cause damage. Signs of inflammation include redness, warmth, swelling, and pain.
Steroids reduce the production of chemicals that cause inflammation. This helps keep tissue damage as low as possible. Steroids also reduce the activity of the immune system by affecting the way white blood cells work.
Steroids are used to treat many conditions in which the body’s defense system doesn’t work properly and causes tissue damage. Steroids may be the main therapy for certain diseases. For other conditions, steroids might only be used sparingly or when other measures have not been successful.
Steroids are used in the treatment for certain rheumatologic inflammatory conditions, such as:
When inflammation threatens to damage critical body organs, steroids can be organ-saving and in many instances, life-saving.
For example, steroids may prevent the worsening of kidney inflammation, which could lead to kidney failure in people who have lupus or vasculitis. For these patients, steroid therapy might eliminate the need for kidney dialysis or transplantation.
Low doses of steroids might provide significant relief from pain and stiffness for people with rheumatoid arthritis. Short-term use of higher doses of steroids might help a person recover from a severe flare-up of arthritis.
The decision to prescribe steroids is always made on an individual basis. Your doctor will consider your age, physical activity, and other medicines you are taking. Your doctor will also make sure you understand the potential benefits and risks of steroids before you start taking them.
The potential benefits and risks of steroids vary with:
The chance of side effects depends on the dose, type of steroid, and length of treatment. Some side effects are more serious than others. Common side effects of systemic steroids include:
Please note: These side effects are the most common side effects. All possible side effects are not included. Always contact your doctor if you have questions about your personal situation.
Not all patients will develop side effects. How often any side effect occurs varies from patient to patient.
If steroid use is brief (from a few days to a few weeks), it is possible that none of the listed side effects will occur. The side effects listed here generally do not occur when occasional steroid injections are given for arthritis, tendonitis, or bursitis. However, if steroid use involves high doses and is prolonged (for a few months to several years), an increase in the number of side effects might occur. The prolonged use of high dose steroids is justified only for severe illnesses that represent serious risks to the patient.
To minimize the side effects of steroids, doctors follow several guidelines:
There are other ways to prevent certain side effects, and these need to be discussed individually with your physician.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition.
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