Corticosteroids are medications chemically related to the natural hormones produced by the adrenal glands, which are located at the top of each kidney.

Corticosteroids are synthetic versions of the natural hormone cortisol. Cortisol plays an important role in controlling salt and water balance in the body and regulating metabolism of carbohydrates, fats and proteins. When the body becomes stressed from infection, trauma, surgery or emotional problems, the adrenal glands produce more cortisol, which helps the body to cope with the stress. When the stress disappears, production of cortisol returns to normal. Cortisol also suppresses inflammation, which is the body’s normal response to outside invaders such as bacteria.

Corticosteroids work by blocking the production of substances in the immune system (such as prostaglandins) that trigger allergic and inflammatory reactions. Some autoimmune disorders also trigger inflammation when they react to normal body tissue as if it were an outside invader. This inflammation may first be treated with nonsteroidal anti-inflammatory drugs (NSAIDs). If NSAIDs do not provide relief from pain or inflammation, corticosteroids may be the physician’s next choice.

Corticosteroids are strong medications. Although they have proven to be helpful in treating many medical disorders, they have side effects that can be serious. The potential risks and benefits should be discussed with a physician before taking them.

People who take corticosteroids for painful conditions such as osteoarthritis, rheumatoid arthritis, gout or temporal arteritistemporal arteritis usually take pills or receive injections. For people with one painful joint, such as a knee, injection therapy can reduce pain and swelling. Corticosteroids injected into a joint can concentrate the medication where it is needed and avoid potential problems. However, continued injections into joints may eventually damage the cartilage.

Most corticosteroids are available only with a physician’s prescription. However, some low-strength topical creams are available over the counter.

People taking corticosteroids for a long period of time should not stop taking them abruptly because they can experience serious side effects. A physician can provide a schedule for safely discontinuing the use of corticosteroids.