Corticosteroids

General Indications

By definition, arthritis is persistent inflammation in a joint, experienced as heat, redness, swelling and pain. Although there are many different pharmaceutical preparations that reduce the inflammation of arthritis, they can be categorized into two broad categories: those that contain cortisone, and those that don't.

Cortisone is derived from human hormones and is extraordinarily effective at regulating inflammation, so much so that it garnered its discoverers a Nobel Prize in the late 1940s. The cortisone used to treat arthritis is a synthetic version of one of the steroids produced by our adrenal glands; another of these naturally occurring hormones is anabolic steroid, which helps build muscle tissue (the synthetic anabolic steroids used illegally by some athletes to build muscle are never used to treat arthritis). Clinical experience has shown that cortisone has its limits, but it's also taught doctors how to use its anti-inflammatory powers wisely and well.

In osteoarthritis (OA) - the most common type of arthritis - the cartilage in a joint seems to slowly 'dry up' and erode away over many years. From time to time, cartilage debris irritates the synovial membrane, causing inflammation. Occasionally a doctor will prescribe an NSAID or, more rarely, a cortisone injection for a severely swollen joint. Very often, however, only acetaminophen is necessary for pain relief; prednisone, the tablet form of cortisone, is never used in managing OA.

In inflammatory arthritis (such as rheumatoid or psoriatic arthritis), the body's immune system mistakenly attacks the soft tissue of the synovial membrane. Defence cells invade the synovium, creating a complex chemical chain of events that ultimately corrodes cartilage and bone, the potential consequence of not treating inflammatory arthritis with appropriate medication, which may include prednisone (cortisone in tablet form) and occasionally cortisone injections. Prednisone is also commonly used to treat the inflammatory symptoms of lupus.

This page was last reviewed/updated on : 02/23/2008