There are two main types of steroids for arthritis: those that are given systemically and those that are administered locally to an affected area. Systemic steroids like prednisone are typically given orally, and are often used in cases where joint pain and stiffness is a continuing problem. Locally administered steroids for arthritis can be broken into two categories: topical and injected. Topical steroids such as hydrocortisone are applied as creams or ointments to the skin over the arthritic joints. Injectable types like cortisone are administered directly into the affected joints to reduce severe bouts of swelling and pain.
For patients with ongoing problems from arthritis, low doses of steroids given systemically may help provide relief. Though systemic steroids are sometimes given intravenously, for arthritis they are normally given orally in pill or liquid form. Patients will likely want to discuss whether the possible benefits outweigh the risks with their doctors prior to taking systemic steroids for arthritis, as the side effects can be quite serious.
Some of the potential risks of continued oral steroid use include an increase in blood pressure, decreased immune function, and osteoporosis. They can also worsen certain conditions like diabetes, and so should be avoided by certain people. In all cases, the lowest effective dose possible should be given to a patient to minimize these risks.
Steroids for arthritis can be applied topically directly over the affected joints that are painful or inflamed. Applying a steroid like hydrocortisone in this manner helps avoid the need for systemic exposure to the drugs, which can decrease the chance of side effects. Side effects are possible, though, and can include redness or acne where the drugs are applied to the skin. They also may not provide a high enough dose for significant relief in severe cases.
A doctor may choose to use an injection of steroids directly to the joint for cases where arthritis is flaring up and particularly painful. This technique helps the doctor ensure that a high dose of the drug goes right to the location where it is needed most. It also allows for the use of a large dose while decreasing the chances of severe side effects that can occur with oral steroids. Steroid injections can have some side effects, however, including infection, skin discoloration, and weakening of the nearby tissues, and so should not be given too frequently.