What role do corticosteroids play in treating arthritis?

What is cortisone? And corticosteroids? When are they used in the treatment of arthritis and what side effects do they have?

Commonly referred to as cortisone, corticosteroids are drugs with the same chemical structure as the hormones (glucocorticoids) produced by the adrenal glands. Naturally occurring glucocorticoids are involved in a variety of bodily functions, including balancing stress response and regulating hormone secretion and inflammatory processes.

Corticosteroids, on the other hand, are drugs that are artificially manufactured in a laboratory. They have been widely used in the treatment of a variety of illnesses for over 65 years. In fact, corticosteroids were first used to treat a 29-year-old woman with rheumatoid arthritis in 1949. The improvement was immediate…as were the side effects. To this day, the side effects associated with corticosteroids make prescribing them a controversial issue.

How do corticosteroids work?

Synthetic corticosteroids act in the same way as the naturally occurring glucocorticoids secreted by the adrenal glands. Their main therapeutic action is immunosuppressant, which explains why they are often used to treat allergic and rheumatic diseases like rheumatoid arthritis.

Treatment plans vary on a case-by-case basis. More often than not, corticosteroids (like prednisone, prednisolone and deflazacort) are taken orally and are absorbed through the gastrointestinal tract, although in severe cases they can be administered intravenously (directly into the bloodstream).

Corticosteroids act directly on the cells, impeding the release of the substances that provoke signs or symptoms of inflammation like pain, heat, redness and swelling. They also stop new cells from rushing to the inflammation site and prolonging the inflammation.

What are they used for?

Corticosteroids are used to control the inflammation associated with arthritis. Their use is generally only recommended during flare-ups, with the person being weaned back off them once symptoms clear up.

What are the side effects?

As previously stated, the use of corticosteroids is a controversial issue. This is because they are known to provoke a variety of side effects when used over prolonged periods of time. Generally speaking, these side effects disappear once treatment has been suspended or the dosage has been lowered. That said, it’s important you read up on what to expect before starting treatment. The most common side effects include Cushing syndrome (provoking central obesity – a build-up of fat on the body and face), acne, increased growth of body hair, increases in blood sugar levels and blood pressure and osteoporosis (bone decalcification). Corticosteroids occasionally cause changes to the immune system, opening the individual up to an increased risk of infections.

As previously stated, it’s important to remember that these side effects are reversible. There are also several things you can do to control a lot of these symptoms. For example, most people (as long as they’re not diabetic) are able to control an increase in blood sugar levels by sticking to a low-calorie diet. If you have diabetes you will need to adjust your treatment and make sure you get your blood sugar levels checked regularly. When it comes to osteoporosis, one of the symptoms that gives most cause for concern, you can protect yourself by increasing the amount of calcium and vitamin D in your diet. Your doctor may decide to prescribe some kind of supplement or a medication to control the osteoporosis.

Remember – your doctor is always the best person to go to for advice if you have any doubts concerning the use of corticosteroids. Let them know your worries and concerns. Your doctor will be able to point you in the right direction.

Arthritis, Treatment, Symptoms, Medication, Diet, Scientific research

Author: Purificación Salgado, Journalist

Last Modification: May 12, 2017

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