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Why do steroids help treat arthritis?

Let’s start off with two facts. Prednisone was approved for use in 1955. It is a corticosteroid that reduces inflammation and so helps to treat arthritis. When a drug has a track record of more than fifty years, you respect its effectiveness. No medication survives in today’s highly competitive market unless it delivers. On that basis alone, it would be right to recommend its continuing use. But, like every other simple truth, this needs just a little qualification.

Your body naturally produces cortisol. This is a hormone and it helps to reduce inflammation by modifying the way in which the immune systems works. Inflammation is actually a good sign. That sounds counter-intuitive so, to explain, when your body is invaded by bacteria, viruses and other foreign matter, your white blood cells gather round to defend you against infections and other damage. That swelling, pain and redness are signs the white blood cells are doing their job. All you have to do is to slow down and let the battle continue. Except that sometimes your immune system does not work as it should. If it becomes overactive, too many white blood cells are released and can cause tissue damage. Prednisone and other steroids reduce the activity level of the immune system and modify the way in which the white blood cells function. This distinguishes them from the anabolic steroids whose function is to build up muscle mass.

Thus, used in low doses over a period of time, Prednisone can reduce the stiffness and pain caused by rheumatoid arthritis. If there is a serious increase in the pain from arthritis, a short burst of a high dose can bring rapid relief by reducing the swelling in the joints. Because there can sometimes be uncertainty as to the extent of an oral dose required, steroids can be injected directly into the tissue close to the affected joints. This has the further benefit that relief comes more immediately and reduces the amount of steroid in your body. Less steroid in your body means a lower risk of side effects. The best course of treatment combines the use of the lowest possible doses of Prednisone with other anti-inflammatories and physical therapy to improve mobility in the joints. This allows the steroid to be used for longer with reduced risk of side effects. Indeed, with constant monitoring of the condition, the dose for Prednisone should be continuously reduced as the condition improves.