Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a 36-step process that started with deoxycholic acid, which was extracted from ox bile .  The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception .  In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone.  The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field.  The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.
Some people experience no disadvantages after getting an injection with corticosteroids. Other people may experience pain or itching at the injection site. Other side effects are: swelling, rash and a red discoloration of the skin. A lot of people may experience headache, nausea, fluent feeling, muscle cramps, hoarse voice, hot flashes and vaginal bleeding.
An important side effect of a corticosteroid injection is that it has a negative effect on the remaining cartilage. This is the main reason that repeated injections are not first choice, although they have a very positive effect on the symptoms in a lot of people. The long term Arthrosis will worsen through these injections because the progressive cartilage wear in turn will induce new inflammation. An injection with corticosteroids is therefore an excellent bridge to (for instance) upcoming joint replacing surgery (hip or knee) but is no permanent solution for Arthrosis.
Most injections into the knee or a smaller joint, like that at the base of the thumb, are simple procedures that can be done in a doctor’s surgery. When performed by an experienced physician, the injection is only mildly uncomfortable.
First, the doctor cleans the skin in the area with an antiseptic. If the joint is puffy and filled with fluid, the doctor may insert a needle into the joint to withdraw the excess fluid and examine it. Removing the fluid rapidly relieves pain also because it reduces pressure in the joint and may speed-up healing. Next, the doctor uses a different needle to inject the corticosteroid into the joint.
Injecting a large joint, like the hip, is more complicated and may require imaging tests to help the doctor guide the needle into the joint. Experienced rheumatologists, orthopaedic surgeons, anaesthetists, and radiologists may inject the facet joints of the lower spine.