Fast Relief vs. Long-Term Damage: The Steroid Dilemma for RA

Introduction to Steroids in RA 0:00

Steroids are probably the most misunderstood part of rheumatoid arthritis treatment. You love them on how fast they stop your pain, but you hate them because of the side effects. If you have ever wondered why your doctor keeps on reaching for the prednisone, This video is for you. We are breaking down exactly what they do in your body and why they are usually a temporary relief. Hi, Rheumatoid Arthritis Warrior. This is Dr. Ananda Subedi, your rheumator arthritis coach at The Room Doc, as well as a practicing rheumeatologist here in Cary, North Carolina.

Today, I'll give you some insight about the Prandesal, the commonly used medication in rheuma arthritis. Before I go further, don't forget to like and subscribe to our channel so that you can keep on watching our videos.

What Rheumatoid Arthritis Is 0:49

Also put a comment in our video so you tell us what you like, what don t like or how we can improve on our Channel. that includes a recipe of an anti-inflammatory smoothie that you can prepare every morning to fight against rheumatoid arthritis, so that, you don't have to resort to the prednisone. And also, accept the free copy of the book, the Holistic Rheumatic Arthritis book that is written just for you. It contains a lot of other information related with rheuma arthritis. Now, before we talk more about Rheumatoid Arthritis, let's also learn more and recap what is RHeumatorid arthritis.

As many of you are aware, rheumatitis is an autoimmune disease where your immune system mystically attacks your healthy joints. It causes chronic inflammation and that leads to persistent pain, swelling and joint stiffness. And it is not just a joint disease, it's a systemic disease with systemic impact.

How Corticosteroids Work 1:49

It can also affect your other organs such as heart and the lungs. That's why it very important to treat early with early intervention. When we talk about the treatment, then comes the use of the steroids or corticosteroids. So the corticosteroids are your own body's very powerful anti-inflammatory chemicals, one of them being cortisol. But the prednisone or methylprednisolone are stronger than the cortisol and they are typically taken as a medication. And what they do, they rapidly reduce inflammation that is happening due to autoimmune disease like rheumatoid arthritis.

They also suppress your overactive immune system, which is the primary driver or the problem in rheumatoid arthritis. By suppressing that over active immune, your body calms down, causing less pain, less swelling and less stiffness. But be aware, the corticosteroids are not the same as the anabolic steroid that sometimes athlete might use.

Bridge Therapy and Flare Treatment 2:57

They are two different medications. The next question that you might think of is why we use steroids. What is the role of corticoid steroids in rheumatoid arthritis? There are 2 main role cortiosteroid in treatment of rheuptoide arthritis. And the first one you can see in the screen is called the bridge therapy. You might recall, when you were initially diagnosed with rheumatoid arthritis, you had a lot of pain, lot swelling, and your doctor might start you on long-term medication called disease-modifying anti-rheumatic drugs.

But the challenge with those drugs is they don't work fast. They take several weeks to even several months and you are in lot pain. So we use corticosteroid to bridge that gap. a gap between when your doctor starts the disease-modifying antirheumatic drugs and when they start working so that you are in less pain. When you're waiting for those medications to kick in, then we use corticosteroids as the bridge therapy. But the important point to remember is, corticoid steroids should not be used long term.

They are just used during the Bridge Therapy. The other time that might also use Corticosteroid are during that acute flares. When you are having suddenly increased amount of pain, increased amounts of stiffness, we call that flares. So your doctor will prescribe corticosteroid during those flares. And we talked about the bridge therapy earlier. When are newly diagnosed, when you're waiting for those disease modifying antirheumatic drugs to be kicking in, then we use this medication. Occasionally, when you have a flare of rheumatoid arthritis affecting one or two joints, your doctor might also inject into those joints with corticosteroids.

Forms of Steroid Treatment 4:46

This is targeted treatment for those specific joints that are inflamed. By doing this local injection steroid, we can minimize long-term side effects. So in general, the corticosteroid could be used in two forms. One is by mouth, a pill form, and also it can be done by injections too. Injection could your joints or it could in your muscles. There are two different ways of giving you corticoid steroids. Beyond the pain relief, here are some of the other benefits with corticosteroids. One is rapid control of rheumatoid arthritis symptoms.

They work fast and help you control your pain much much better. Some studies have also shown that cortisosteroid do also have joint protection properties, particularly in the early phase of disease,

Benefits and Safety Considerations 5:34

that can help reduce the joint damage. Because of pain reduction and stiffness reduction, it can also improve your quality of life. You will be more mobile and more active because of less pain by the use of these medications. Now here is the important slide that you need to remember. closely with your rheumatologist and your doctor on how you are taking your corticosteroids. It has to be taken very safely. So always use corticoid under close supervision with you primary care doctor or your Rheumatoidist.

And the next important point, never stop cortisosteroid cold turkey, which it can cause we call adenyl crisis. or your adenoid gland might shut down and causing other major medical problems. So if you have concern with the side effects, always discuss with your rheumatologist before stopping urticosteroids. And other very important thing to remember. Another very key concept to remember in corticosteroid is the fourth point. The goal of treatment with cortisosteroids is to use the lowest effective dose for the shortest duration of time.

So try your best not to used too long or not too high dose. The corticosteroids could be a powerful tool in empowering you in your RA journey. It could help you quickly manage rheumatoid arthritis flares or it can be bridge therapy where your long-term medications are not active yet. So use them as a very powerful tools and be very strategic on how you are using the cortisosteroid. Use them not as long term solution. and also work closely in partnership with your doctor so that you take the right dose for right duration of time.