Corticosteroids were among the first powerful drugs used for fighting arthritis inflammation. Cortisone, the first corticosteroid drug, came on the market around 1950 and was seen as a miracle treatment. But these drugs can carry serious side effects if taken at higher doses. Lower doses and tapered doses of oral corticosteroids may help reduce these effects.

Corticosteroid injections into a joint may deliver a powerful dose of medicine directly to the source of pain, but these shots, given many months apart, may not carry the same systemic side effects as the oral drugs.

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Disease-modifying antirheumatic drugs, or DMARDs, are a class of medications that suppress the body’s immune system. In some forms of arthritis, such as rheumatoid arthritis, psoriatic arthritis and lupus, the system malfunctions, causing damaging joint and organ inflammation. These conditions are known as autoimmune diseases, because the body’s disease-fighting mechanisms turn against the body’s tissues and destroy them by mistake.

DMARDs, which are strong, prescription-only drugs, fight the out-of-control immune process, thereby reducing inflammation, swelling, stiffness and pain. DMARDs are designed for long-term use, and often are taken along with other medications like NSAIDs, corticosteroids or analgesics to fight pain.

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Under the general umbrella of DMARDs is a new, more powerful, targeted class of drugs called biologic response modifiers, or biologics. Like DMARDs, biologics suppress the malfunctioning immune system’s production of certain inflammatory proteins in diseases like RA, ankylosing spondylitis and others. By stopping the body from mistakenly producing these substances, biologics greatly reduce inflammation. They can even stop joint damage from occurring. They cannot cure you, but they can, in many cases, put these diseases into remission.

Biologics, only available since 1998, are all prescription drugs, given either as pills, intravenous infusions or as subcutaneous injections. Some biologics are prescribed along with the DMARD methotrexate; some may only be prescribed after DMARDs have failed to produce results.

Biologics can work quickly and powerfully to reduce inflammation and pain. However, because they suppress the body’s immune system, they can increase your susceptibility to infections. So careful monitoring by your doctor is essential. Biologics must be taken and stored according to instructions in order to work, as they are live cells. Biologics are also expensive and may or may not be covered by your insurance plan.

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After first prescribing these drugs to treat the neurochemical imbalances that may cause depression symptoms, doctors learned that antidepressants could also reduce patients’ pain. That’s because the same body chemicals that can affect mood may also cause pain.