Corticosteroids

How They Work

Corticosteroids are synthetic versions of cortisol that powerfully reduce inflammation. They work by suppressing immune responses and blocking inflammatory chemicals.¹

Forms

Oral Steroids

• Prednisone, prednisolone
• Methylprednisolone (Medrol dose pack)
• Dexamethasone
• Used for short bursts typically

Injectable Steroids²

• Joint injections
• Epidural steroid injections
• Trigger point injections
• Longer acting (triamcinolone, methylprednisolone)

Conditions Treated

• Inflammatory arthritis flares
• Radiculopathy
• Cluster headaches (bridge therapy)
• Autoimmune conditions
• Severe osteoarthritis flares
• Bursitis, tendinitis

Short-Term Side Effects³

• Increased appetite, weight gain
• Insomnia
• Mood changes
• Elevated blood sugar
• Fluid retention

Long-Term Risks

• Osteoporosis
• Adrenal suppression
• Diabetes
• Cataracts
• Weight gain
• Skin thinning
• Infection risk

Important Considerations

• Short-term use preferred when possible
• Must taper if used more than 1-2 weeks
• Limit injection frequency (3-4x/year per joint)
• Monitor blood sugar in diabetics

References

1. Coutinho AE, Chapman KE. The anti-inflammatory and immunosuppressive effects of glucocorticoids. Mol Cell Endocrinol. 2011;335(1):2-13.
2. MacMahon PJ, Eustace SJ, Kavanagh EC. Injectable corticosteroid and local anesthetic preparations: a review. Radiology. 2009;252(3):647-661.
3. Poetker DM, Reh DD. A comprehensive review of the adverse effects of systemic corticosteroids. Otolaryngol Clin North Am. 2010;43(4):753-768.