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Steroids

Reviewed by: HU Medical Review Board | Last reviewed: January 2023

Steroids, also called glucocorticoids or corticosteroids, are drugs that act like the hormone cortisol. Cortisol is a hormone made by your adrenal glands. It plays a role in many different body functions, including inflammation.1

Long-term treatment with steroids is not recommended for axial spondyloarthritis (axSpA). Over time, steroids may lead to serious health problems such as weak bones, high blood pressure, and diabetes. But in some cases, steroids may be used as a short-term treatment to reduce severe pain and inflammation.2,3

How do steroids work?

Steroids help reduce inflammation in your body when you take them in higher doses than your body naturally makes. They do this in several ways:1,3

  • They block the release of certain chemicals in the body that cause inflammation.
  • They help reduce the swelling and redness that come with inflammation.
  • They can suppress the immune system, which helps reduce inflammation overall.

In people with axSpA, inflammation is a major cause of pain and disability. Steroids are sometimes used to help reduce this inflammation and its symptoms. But these drugs should be used only if other treatments have not worked or if you have a sudden flare-up of symptoms.2

You can take steroids in a pill form to reduce overall inflammation. Your doctor may also suggest steroid injections to target specific areas of inflammation. Steroids can be injected into the muscle or joint.2

Examples of steroids

There are many different steroids available. They include:4

  • Betamethasone
  • Cortisone
  • Dexamethasone
  • Fludrocortisone
  • Hydrocortisone
  • Methylprednisolone
  • Prednisolone
  • Prednisone
  • Triamcinolone

What are the possible side effects?

Like all medicines, steroids can cause side effects. The side effects of steroids vary from person to person. They can vary depending on the specific drug you are taking. They also usually depend on how much of the drug you take and for how long. If you take a higher dose or take it for a longer time, you are more likely to have more severe negative side effects.1,3

Short-term side effects of steroids may include:1,3,4

  • High blood pressure
  • Mood swings, behavior changes, and confusion
  • Trouble sleeping
  • Stomach upset
  • High blood sugar, which can cause or worsen diabetes

Side effects of long-term steroid use may include:1,3,4

  • Weakening of bones (osteoporosis)
  • Cataracts, glaucoma, and other eye problems
  • Increased risk for infections
  • Swelling in the feet and legs
  • Puffiness of the face (moon face)
  • Weight gain

These are not all the possible side effects of steroids. Talk to your doctor about what to expect when taking steroids. You should also call your doctor if you have any changes that concern you when taking steroids.1,3

Other things to know

Steroids are potent medicines and should only be used as prescribed by your doctor. Take steroids as directed and for the full amount of time prescribed. Do not stop taking them suddenly, as this can cause serious side effects.1

Each person must carefully weigh the risks of using steroids against the benefits. Long-term use of steroids can cause serious side effects. Take them only if you need them. Your doctor will monitor you for side effects from long-term steroid use.1-3

Tell your doctor if you have any signs of infection, such as fever, chills, or sore throat. These could be signs of an infection that could worsen while taking steroids.3

Before beginning treatment with steroids, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you take. This includes over-the-counter drugs.

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