There are some physicians who are still strongly prejudiced against the use of steroids for arthritis. However, the prevailing practice seems to be that, although potentially hazardous, there is a role for cortisone in the treatment of connective tissue diseases. Most rheumatologists exhaustively search for a less toxic alternative to steroids but readily prescribe it during life-threatening situations if milder medications are ineffective. In addition, most rheumatologists believe that, when used cautiously in carefully selected situations, corticosteroids can be useful in the treatment of inflammatory arthritis. Physicians try to prescribe the lowest effective dose, recommend it for the briefest possible time and, when feasible, substitute a medication more appropriate for long-term use.
Corticosteroids are available in several forms.
Creams and ointments are used to treat rashes and other skin problems. Corticosteroid pills are prescribed, when necessary, only for inflammatory types of arthritis, such as rheumatoid arthritis, polymyalgia rheumatica and systemic lupus erythematosus. Prednisone, which comes in many different strengths and brand names, is the most commonly prescribed cortisone pill. Cortisone pills are not prescribed for noninflammatory joint conditions, such as osteoarthritis or fibrositis. This also applies to cortisone when injected into the muscle or vein.