Corticosteroids provide short-term relief for many chronic pain conditions. They are some of the most powerful medicines available to fight inflammation. However, long-term use of corticosteroids may lead to numerous side effects, including diabetes. Some of the strongest side effects are associated with the oral and intravenous forms of corticosteroids, which are used for pain. Physicians may try to minimize the side effects by prescribing as low a dose as possible for pain relief and by using corticosteroids for severe pain only.

Corticosteroids can cause a form of Cushing’s syndrome. This condition can also result from overproduction of adrenal hormones due to diseases such as cancer. Symptoms of Cushing’s syndrome include weight gain (notably in the abdomen), fleshiness in the face, accumulation of fat between the shoulders, back pain, unexplained euphoria, headache, erectile dysfunction or amenorrhea (absence of menstruation), and skin changes including acne, increased bruising and formation of purple lines on the thighs, belly and breasts. Drug-induced Cushing’s syndrome generally resolves after the medication is discontinued.

Common side effects of corticosteroids include:

• Oral and intravenous:
  
  
• Suppression of the immune system, increasing likelihood for infection
• Bone loss, which may lead to or exacerbate osteoporosis
• Cartilage damage after repeated injections
• Acne
• Weight gain
• Mood swings
• Delayed growth (in children)
• Blurred vision
• Excessive urination (polyuria)
• Increased thirst (polydipsia)
• Increased appetite (polyphagia)
• Indigestion
• Flushing of face or cheeks
• Increase in glucose (blood sugar)
  
  
• Ointments/drops:
  
  
• Eye infection
• Eye pain
• Gradual blurring or loss of vision
• Nausea/vomiting
  
  
• Inhaled corticosteroids:
  
  
• Sore mouth or throat, hoarseness
• Coughing
• Thrush (fungal infection in the mouth)
• Decrease in bone thickness
• High pressure or fluid buildup in the eye
  
  
• Nasal spray corticosteroids:
  
  
• Increased chance of bruising
• Skin or muscle wasting
• Weight gain or fluid retention
• Decrease in bone density
• Damage to bones and bone cells (avascular osteonecrosis)
• Increased blood pressure
• Increased risk of ulcer
• Increased risk of eye complications, such as glaucoma or cataracts
  
  
• Topical corticosteroids:
  
  
• Skin blisters filled with blood
• Itching or burning skin
• Increased skin sensitivity
• Numbness in the fingers
• Increased chance of bruising
• Raised red spots on the skin
  
  
• Enemas/foams/suppositories:
  
  
• Burning or itching of skin
• Diarrhea
• Infection
• Rectal bleeding
• Sensation of pins and needles
  
  
• Pastes:
  
  
• Infection
• Irritation, such as burning, itching, blistering or peeling
  

Some side effects of corticosteroid drugs are considered more dangerous, though rare. An individual should immediately contact a physician if they experience any of these side effects:

• Loss of vision or eye pain
• Unusual confusion or excitement
• Hallucinations
• Mental depression
• Irregular heartbeat
• Bloody stool
• Unusual increase in hair growth
• Vomiting