The inflammatory response is a part of your innate immune system that responds to infection and injury. Contemporary medicine uses various medications and methods to relieve or reduce the patient’s pain during these processes. In medical care, steroids are one of the most widely used drugs that are given in cases of severe pain. However, while it is commonly used given for severe inflammatory pain associated with rheumatoid arthritis, it is less likely to be applied for acute surgical pain despite the substantial need for them. Thus, exploring the rationale for such discrepancy in using this drug is fundamental to discovering the primary reasoning for such a matter.
Steroids are used to help control many forms of pain in multiple types of diseases. Steroids are naturally occurring chemicals produced in the two adrenal glands located above the kidneys (Steroids used in rheumatoid arthritis, n.d.). Adjuvant treatment with steroids is especially effective for metastatic bone pain, neuropathic pain, and abdominal pain. This drug is injected directly into the epidural cavity, delivering an anti-inflammatory effect and removing inflammatory compounds. Thus, steroids are highly effective when applicable during severe inflammatory pains.
Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic autoimmune disease that affects the joints in various forms and severity among people (Bullock et al., 2018). Joint pain is a common symptom among RA patients, requiring comprehensive management. The ultimate aim of first-line care is to alleviate pain and reduce inflammation, and corticosteroids are incredibly successful in this regard. Though these steroids are highly potent and may come with severe side effects, thus, are only prescribed at low doses for a brief period of time during RA exacerbations or flares. Therefore, steroids for reducing rheumatoid arthritis inflammation must be used with caution, and the doctor must weigh a number of factors before administering the medication.
While steroids are widely used for pain prevention in RA, acute surgical pain is rarely reduced by these drugs, despite the that inflammation is a major source of postoperative pain. Management of acute postoperative pain after elective surgery is an issue in healthcare, with reports indicating that up to 75% of patients experience insufficient pain relief in the immediate postoperative period (Mohammad et al., 2017). Steroids are rarely used to decrease post-surgical pain, mainly due to the lack of substantial studies exploring their efficiency. The main precaution of using these medications for acute surgical pain management is related to their side effects, which include an increased risk of infections, osteoporosis, wound dehiscence, and muscle weakness (Mohammad et al., 2017). Thus, healthcare providers use medication requiring less management and chances of developing new conditions.
Despite the fact that similar symptomatic, steroids are not applied evenly in rheumatoid arthritis inflammation and acute surgical pain relief. While no definitive statement of poor management of RA is found, multiple studies disclose patient surveys indicating poor management of postoperative pain (Gan, 2017). Although steroids may enact certain side effects, this drug has shown sufficient impact on the inflammation reduction for rheumatoid arthritis, which must serve as evidence for its broader application in acute surgical pain control.
To conclude, inflammatory processes are highly prevalent in many diseases and serve as a natural reaction of the body to the infection. Steroids demonstrate a great effect in treating rheumatoid arthritis inflammation, commonly used in short-term treatment. However, post-operational rashes are much less managed by steroids, despite their high efficiency. Based on the evidence of surveys and steroid’s medical effects, patients would significantly benefit from injecting steroids during acute surgical pain.
References
Bullock, J., Rizvi, Syed A. A., Saleh, Ayman M., Ahmed, Sultan S., Do, Duc P., Ansari, Rais A., & Ahmed, J. (2018). Rheumatoid arthritis: A brief overview of the treatment. Medical Principles and Practice, 27(6), 501–507.
Gan, T. J. (2017). Poorly controlled postoperative pain: prevalence, consequences, and prevention. Journal of Pain Research, Volume 10, 2287–2298.
Mohammad, H. R., Trivella, M., Hamilton, T. W., Strickland, L., Murray, D., & Pandit, H. (2017). Perioperative adjuvant corticosteroids for post-operative analgesia in elective knee surgery – A systematic review. Systematic Reviews, 6(1).
Steroids are used in rheumatoid arthritis (RA). (n.d.). NRAS.