Rheumatoid Arthritis Health Center
Arthritis: Steroids to Treat Arthritis
Steroids (short for corticosteroids) are synthetic drugs that closely resemble cortisol, a hormone that your body produces naturally. Steroids work by decreasing inflammation and reducing the activity of the immune system. They are used to treat a variety of inflammatory diseases and conditions.
Corticosteroids are different from anabolic steroids, which some athletes use to build bigger muscles. Examples of corticosteroid medications include triamcinolone, cortisone, prednisone and methylprednisolone.
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How Are Steroids Given?
Steroids can be given topically, by mouth (orally) or by injection. When injected, they can be given into a vein or muscle, directly into a joint or bursa (lubricating sac between certain tendons and the bones beneath them) or around tendons and other soft tissue areas.
How Do Steroids Work?
Steroids decrease inflammation and reduce the activity of the immune system. Inflammation is a process by which the body's white blood cells and chemicals protect the body against infection and foreign substances such as bacteria and viruses.
In certain diseases, however, the body's defense system (immune system) doesn't function properly and is overactive. This may cause inflammation to work against the body's own tissues and cause tissue damage. Inflammation is characterized by redness, warmth, swelling and pain.
Steroids reduce the production of inflammatory chemicals in order to minimize tissue damage. Steroids also reduce the activity of the immune system by affecting the function of white blood cells.
What Conditions Are Treated With Steroids?
Steroids are used to treat a variety of conditions in which the body's defense system malfunctions and causes tissue damage. Steroids are used as the main treatment for certain inflammatory conditions, such as systemic vasculitis (inflammation of blood vessels) and myositis (inflammation of muscle). They may also be used selectively to treat inflammatory conditions such as rheumatoid arthritis, lupus, Sjögren's syndrome, or gout.
What Are the Benefits of Steroids?
When inflammation threatens to damage critical body organs, steroids can be organ saving and, in many instances, life-saving. For example, they may help prevent the progression of kidney inflammation, which can lead to kidney failure in people who have lupus or vasculitis. For these people, steroid therapy may eliminate the need for kidney dialysis or transplantation.
Low doses of steroids may provide significant relief from pain and stiffness for people with conditions including rheumatoid arthritis. Temporary use of higher doses of steroids may help a person recover from a severe flare-up of arthritis.
Why Are Steroids Injected?
Injecting steroids into one or two areas of inflammation allows doctors to deliver a high dose of medication directly to the problem area. When doctors give steroids by mouth or in a vein, they cannot be sure an adequate amount will eventually reach the problem area.
What Conditions Are Treated With Steroid Injections?
Steroids often are injected directly into joints to treat conditions such as rheumatoid arthritis, gout or other inflammatory diseases. They also can be injected into inflamed bursae or around tendons near most joints in the body.
Some people report relief from osteoarthritis when steroids are injected directly into swollen or painful joints.
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Important Safety Information
Cymbalta® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.
What should I talk about with my healthcare provider?
Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.
You should also know that:
- Suicide is a known risk of depression and some other psychiatric disorders.
- Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
- All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
- Cymbalta® is not approved for use in patients under age 18.
Who should NOT take Cymbalta?
You should not take Cymbalta if:
- You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
- You have uncontrolled narrow-angle glaucoma (an eye disease)
- You are taking Mellaril® (thioridazine)
What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:
- about all of your medical conditions, including kidney problems, glaucoma, or diabetes
- about your alcohol use
- if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
- if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
- if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant
While taking Cymbalta, tell your healthcare provider:
- if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
- if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
- before stopping Cymbalta or changing your dose
- if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta
If you have any questions, talk to your healthcare provider before taking Cymbalta.
What are the possible side effects of Cymbalta?
The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.


