“Cortisone” is the word most people use for corticosteroids generally — the powerful anti-inflammatory medicines given as tablets, injections, creams, inhalers and drops. They treat inflammation of almost any cause, and they are among the most useful and most misunderstood medicines in ordinary use.
What is Cortisone?
Cortisone is a specific medicine, but the word is used far more broadly. When someone says “cortisone injection” or “cortisone tablets”, they nearly always mean a corticosteroid — most often prednisone, methylprednisolone, betamethasone or dexamethasone.
Corticosteroids are synthetic versions of cortisol, the hormone your adrenal glands produce naturally. Cortisol regulates inflammation, the immune response, blood sugar and the body’s response to stress.
How they work. Corticosteroids enter cells and switch off the genes that produce inflammatory proteins, while switching on genes that produce anti-inflammatory ones. It is a broad, powerful action affecting inflammation of almost any cause — which is why one class of medicine treats asthma, eczema, arthritis, allergy, bowel disease and much else.
They differ in strength and duration, which is why there are so many:
| Medicine | Relative potency | Duration |
|---|---|---|
| Hydrocortisone | 1 (weakest) | Short |
| Prednisone / prednisolone | 4 | Intermediate — the usual oral choice |
| Methylprednisolone | 5 | Intermediate |
| Betamethasone / dexamethasone | 25–30 | Long-acting |
The form matters as much as the medicine. A steroid cream acts mostly where it is applied; an inhaler acts mostly in the airways; an injection into a joint acts mostly in that joint. Tablets affect the whole body, and that is where nearly all the significant side effects come from.
Two things are widely misunderstood.
These are not anabolic steroids. Corticosteroids reduce inflammation; anabolic steroids are testosterone derivatives used to build muscle. Completely different medicines, completely different effects.
Short courses and long courses are different propositions. A five-day course for an asthma flare carries very little risk. Months of daily tablets is a different medicine entirely in terms of consequences.
What is Cortisone commonly used for?
- Asthma and COPD flares, as short oral courses, and daily as inhalers.
- Severe allergic reactions, hay fever and hives.
- Eczema, psoriasis and dermatitis, as creams and ointments.
- Rheumatoid arthritis, lupus and other autoimmune disease, to control inflammation.
- Joint, tendon and bursa injections — shoulder, knee, hip, tennis elbow, carpal tunnel.
- Inflammatory bowel disease flares.
- Gout, as an alternative to anti-inflammatories.
- Certain cancers, as part of chemotherapy regimens.
- Adrenal insufficiency (Addison’s disease), where they replace a hormone the body cannot make. This use is entirely different — it is replacement, not treatment, and must never be stopped.
- Croup in children, as a single dose.
- Preventing lung problems in premature babies, given to the mother before delivery.
On joint injections specifically, since these are what people usually mean by “a cortisone injection”: they reduce pain and inflammation effectively, usually within days, and the effect lasts weeks to months. They do not repair the joint, and repeated injections into the same joint can weaken cartilage and tendon — which is why most clinicians limit them to a few per joint per year, and why physiotherapy alongside matters more than the injection itself.
How Cortisone fits into this medicine category
| Group | Examples | Notes |
|---|---|---|
| Oral corticosteroids | Prednisone, methylprednisolone, dexamethasone | Whole-body effect; short courses preferred |
| Topical steroids | Hydrocortisone, betamethasone creams | Mostly local; skin thinning with prolonged use |
| Inhaled steroids | Budesonide, fluticasone | Asthma prevention; minimal whole-body effect |
| Injected steroids | Methylprednisolone, triamcinolone | Joints, tendons, bursae |
| NSAIDs | Ibuprofen, diclofenac | Anti-inflammatory, different mechanism |
| Disease-modifying | Methotrexate, biologics | Change the disease course; steroids do not |
| Anabolic steroids | Testosterone derivatives | Unrelated medicines |
Steroids control inflammation; they do not cure the underlying disease. In rheumatoid arthritis and similar conditions they buy time while disease-modifying treatment takes effect.
See the pain, inflammation and musculoskeletal medicines hub.
What to check before using Cortisone
The single most important rule: do not stop a longer course abruptly. After more than about two to three weeks of oral steroids, your adrenal glands reduce their own cortisol production. Stopping suddenly can cause an adrenal crisis — collapse, low blood pressure, vomiting and, untreated, death. Longer courses are always tapered.
Tell your doctor or pharmacist if you:
- Have diabetes. Steroids raise blood sugar substantially, and monitoring needs tightening during a course.
- Have an infection, or have been exposed to chickenpox, shingles, measles or tuberculosis. Steroids suppress immunity, and infections can worsen quietly.
- Have high blood pressure, heart failure, glaucoma or cataracts.
- Have stomach ulcers, or take anti-inflammatories — the combination substantially raises bleeding risk.
- Have osteoporosis. Long-term steroids cause bone loss, and calcium, vitamin D and sometimes a bisphosphonate are prescribed alongside.
- Have a history of depression, bipolar disorder or psychosis. Steroids cause mood changes, sometimes marked.
- Have epilepsy, thyroid disease, liver or kidney disease.
- Are pregnant or breastfeeding.
- Are due for a vaccination — live vaccines are avoided.
- Are giving it to a child, where growth can be affected by prolonged use.
Practical points:
- Take tablets in the morning with food, which reduces sleep disturbance and stomach upset.
- Complete the course as prescribed, and do not extend it yourself.
- Carry a steroid card if you take them regularly or repeatedly.
- Tell any other prescriber, dentist or emergency doctor that you take steroids.
- You may need extra steroid during serious illness or surgery — this is called sick-day dosing and your doctor will explain it if it applies.
Possible cautions and when to ask a pharmacist or doctor
Short courses commonly cause increased appetite, difficulty sleeping, restlessness or a lift in mood, indigestion, fluid retention and raised blood sugar.
Longer courses add: weight gain and a rounder face, thin fragile skin and easy bruising, muscle weakness, bone loss, cataracts, raised blood pressure, and increased infection risk.
Get emergency help for:
- Collapse, severe weakness, vomiting or confusion, particularly if steroids were recently stopped or reduced — possible adrenal crisis.
- Signs of serious infection — high fever, confusion, severe sore throat, breathlessness.
- Severe abdominal pain, vomiting blood, or black tarry stools.
- Sudden vision changes or eye pain.
- Severe mood disturbance, confusion, or thoughts of self-harm.
Seek prompt advice for:
- Rising blood sugar readings, if you have diabetes.
- New mood changes, agitation or insomnia that are troubling you.
- Swelling of the ankles or rapid weight gain.
- Any infection developing — steroids mask the usual signs.
- Muscle weakness, particularly in the thighs and shoulders.
- New back pain, which can indicate a spinal fracture from bone loss.
Contact your doctor if:
- You need repeated courses. That signals the underlying condition needs better control, not more steroids.
- You have been on them more than three months without a bone protection discussion.
- You want to stop, so it can be tapered.
- You are considering a joint injection and have had several into the same joint already.
Related medicine guides
- Browse Pain, Inflammation & Musculoskeletal Medicines guides
- Read: Prednisone used for
- Read: Donapan used for
Frequently asked questions
What are cortisone tablets used for? Reducing inflammation — asthma flares, allergic reactions, arthritis, autoimmune disease, inflammatory bowel disease and more. “Cortisone” is usually shorthand for a corticosteroid such as prednisone.
Are they the same as anabolic steroids? No. Corticosteroids reduce inflammation; anabolic steroids are testosterone derivatives used to build muscle. Completely different medicines.
Can I stop them suddenly? Only a short course as prescribed. After more than two to three weeks, stopping abruptly can cause adrenal crisis, which can be fatal. Longer courses are tapered.
Do cortisone injections fix my joint? No. They reduce pain and inflammation for weeks to months. They do not repair the joint, and repeated injections into the same joint can weaken cartilage and tendon.
Will they make me put on weight? Short courses increase appetite. Longer courses cause genuine weight gain and a rounder face, which reverses when the steroid is stopped.
Why do they raise my blood sugar? Cortisol raises blood glucose naturally, and corticosteroids do the same. If you have diabetes, monitoring needs tightening during a course.
Are they safe in pregnancy? Often used when needed, including to help a premature baby’s lungs. Discuss it with your doctor.
Why do I need a steroid card? So that in an emergency, anyone treating you knows your body may not produce enough cortisol on its own and you may need extra.