Treatment of arthritis. The role of cortisone, steroids

There are many cultural differences in patients' understanding of and acceptance of treatment. In the United States I was able to explain to patients that they needed a short course of prednisolone to rapidly control symptoms while other medications have time to work. No one likes to take steroids but patients ould accept my explanation and be willing to take short courses of treatments. However, in Dubai people have a deep distrust and fear of steroids. The moment I mention the medication I am greeted with expressions of suspicion.

The use of steroids is not just to control symptoms but for quick, effective reduction in inflammation. Steroids have received bad press because some patients are left on these medications at high doses for many months, sometimes years. In this situation it can cause weight gain, moon face, brittle bones, hypertension etc. In the short term it is rapidly effective, safe, and sometimes life saving. Hench, who discovered prednisolone won the Nobel prize for his discovery in 1947. One of the first people to be treated with prednisolone for arthritis was famous painter Raoul Dufy in Boston. The key to using steroids is lowest doses for shortest duration of time.