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What Are Corticosteroid Injections?

Corticosteroids, also called glucocorticoids or steroids, are drugs that are designed to mimic cortisol, a hormone produced by the adrenal glands that has anti-inflammatory effects. Corticosteroids are used as a treatment for psoriatic arthritis (PsA) to reduce the joint inflammation caused by the disease. Corticosteroids may be taken by mouth or may be injected directly into affected joints, providing temporary relief from joint swelling. Corticosteroids include prednisone, methylprednisolone, prednisolone, dexamethasone, and hydrocortisone.1,2

Uses of corticosteroids

Corticosteroids are used in the treatment of several conditions, including arthritis, asthma, lupus, multiple sclerosis, skin conditions like eczema and rashes, and some kinds of cancer. For skin conditions, corticosteroids are applied in a cream or ointment. For asthma, corticosteroids can be inhaled.2,3 The dose of corticosteroid required depends upon symptoms and individual patient needs. For a flare of symptoms, people with PsA may be prescribed a Medrol® Dosepak (methylprednisolone) or short-term course of steroids beginning with a higher dose and gradually tapering down.

How corticosteroids work

Corticosteroids suppress multiple inflammatory pathways in the body, including genes that are responsible for producing cytokines, enzymes, receptors and proteins that are activated during the inflammatory process.4 Corticosteroids will usually begin working within 1-3 days, although some patients need up to a week to feel the benefits.5

Possible side effects

Corticosteroids are strong medicines that carry a risk of complications and are generally used for as short a time as possible. Side effects and complications of corticosteroid injections may include death of nearby bone, joint infection, nerve damage, thinning of skin and soft tissue around the injection site, temporary flare of pain and inflammation in the joint (for up to 48 hours after injection), tendon weakening or rupture, thinning of nearby bone (osteoporosis), and whitening or lightening of the skin around the injection site.5

Repeated use of corticosteroid injections may cause deterioration of the cartilage in a joint. Physicians usually limit the number of injections, and corticosteroid injections are generally not given more frequently than every six weeks, and usually not more than three or four times a year.5

Common side effects experienced with oral corticosteroids are fluid retention, changes in blood sugar, high blood pressure, changes in behavioral and mood, increased or decreased appetite, weight gain, upset stomach and difficulty falling asleep or staying asleep. Mood changes include irritability, or abnormally happy or excited mood. This is not a complete list of adverse effects. 5

Other precautions

People who take blood thinners may need to stop using their medication for several days before a corticosteroid injection to reduce their risk of bleeding or bruising. Consult with your healthcare professional before stopping any medication.5

People with diabetes may experience a temporary increase in their blood sugar levels following a corticosteroid injection.5

Following the injection, patients are advised to protect the injected area for a couple days, avoid strenuous activity, and apply ice as needed to relieve pain. Patients should watch for any signs of infection at the injection site, such as increased pain, redness or swelling that lasts more than 48 hours.5

Long-term use of corticosteroids has additional complications, including altered response to physical stress, weight gain, and mood changes.2

People who have taken oral corticosteroids for more than two weeks and who stop suddenly may experience withdrawal effects, including fatigue, joint pain, muscle stiffness, muscle tenderness, or fever. To avoid these effects, patients are usually tapered off corticosteroids slowly.2

Written by: Emily Downward | Last reviewed: January 2019.
  1. Psoriatic arthritis treatment. Arthritis Foundation. Available at http://www.arthritis.org/about-arthritis/types/psoriatic-arthritis/treatment.php. Accessed 3/19/18.
  2. Fields TR. Steroid side effects: how to reduce corticosteroid side effects. Hospital for Special Surgery. Available at https://www.hss.edu/conditions_steroid-side-effects-how-to-reduce-corticosteroid-side-effects.asp. Accessed 3/19/18.
  3. Steroids. Medline Plus, U.S. National Library of Medicine. Available at https://medlineplus.gov/steroids.html. Accessed 3/19/18.
  4. Barnes PJ. How corticosteroids control inflammation: Quintiles Prize Lecture 2005. Br J Pharmacol. 2006 Jun:148(3):245-254.
  5. Cortisone shots, Mayo Clinic. Available at https://www.mayoclinic.org/tests-procedures/cortisone-shots/about/pac-20384794. Accessed 3/19/18.