Corticosteroid Injections for Psoriatic Arthritis

Corticosteroids are used as a treatment for psoriatic arthritis (PsA) to reduce the joint inflammation and skin lesions caused by the disease. Corticosteroids may be taken by mouth, used as a topical cream, or injected directly into affected joints to provide temporary relief from joint swelling. Corticosteroids are also called glucocorticoids or steroids.^1,2

Corticosteroids are drugs that are designed to mimic cortisol. Cortisol is a hormone that has anti-inflammatory effects on the body. Your body naturally produces cortisol in the adrenal glands.¹

How do corticosteroid injections work?

Because corticosteroids are similar to the anti-inflammatory hormone cortisol, they help reduce inflammation. Corticosteroids also suppress the immune system. This can help control conditions that cause your immune system to attack healthy tissues by mistake, like PsA.^1,2

Examples of corticosteroids

Corticosteroids used to treat PsA include:^2,3

• Prednisone
• Methylprednisolone
• Prednisolone
• Dexamethasone
• Hydrocortisone

What are the possible side effects?

Side effects can vary depending on the specific drug you are taking and the dose that is prescribed. Repeated use of corticosteroid injections may cause breakdown of the cartilage in a joint. Injections are generally not given more often than every 6 weeks and usually not more than 3 or 4 times a year.^3,4

Side effects of corticosteroid injections may include:^3,4

• Death of nearby bone
• Joint infection
• Nerve damage
• Thinning of skin and soft tissue around the injection site
• Temporary pain and inflammation in the joint
• Tendon weakening or rupture
• Thinning of the bone (osteoporosis)
• Whitening or lightening of the skin around the injection site

Side effects of oral corticosteroids may include:^3,4

• Fluid retention
• Changes in blood sugar
• High blood pressure
• Changes in behavior and mood
• Infection
• Weight gain
• Upset stomach
• Eye problems
• Trouble falling asleep or staying asleep

These are not all the possible side effects of corticosteroids. Talk to your doctor about what to expect when taking corticosteroids. You also should call your doctor if you have any changes that concern you when taking corticosteroids.

Other things to know

People who take blood thinners may need to stop using their medicine for several days before a corticosteroid injection to reduce their risk of bleeding or bruising. Talk to your doctor before stopping any medicine.⁴

After a corticosteroid injection, people are advised to protect the injected area for several days. Avoid strenuous activity, and apply ice as needed to relieve pain. Do not take a bath or use a hot tub (showers are okay). Watch for any signs of infection at the injection site, such as increased pain, redness, or swelling that lasts more than 48 hours.⁴

People who have taken oral corticosteroids for more than 2 weeks and who stop suddenly may experience withdrawal effects. These effects may include fatigue, joint pain, muscle stiffness, muscle tenderness, or fever. To avoid these effects, people usually slowly taper off corticosteroids.³

Before beginning treatment for PsA, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.