Physician Prescribing Patterns of Oral Corticosteroids for Musculoskeletal Injuries

Background: There is considerable controversy as to when and if oral corticosteroids are indicated for musculoskeletal injury. Although the perception is that sports medicine physicians prescribe oral corti-costeroids frequently, there is no documentation of this behavior in the literature. The purpose of this study was to obtain a description of the corticosteroid-prescribing patterns of primary care sports med-icine physicians and look for common indications. Methods: A two-page questionnaire was included in the registration packets of 195 physicians at a national sports medicine conference. Results: Ninety-nine questionnaires were returned. Fifty-eight (58.6%) of the physicians reported prescribing oral corticosteroids for musculoskeletal injuries. Physicians who prescribed corticosteroids for injuries averaged 6.6 prescriptions per month. Prednisone was the corticosteroid prescribed by 82% of physicians. The average prescription length was 7 days. One half of the physicians (51.7%) tapered the dose. The most common starting dose (mode) was 60 mg. Conclusions: Despite little evidence to support their use, primary care sports medicine physicians commonly prescribe corticosteroids. (J Am Board Fam Pract 2003;16:209–12.) Corticosteroids are the most potent anti-inflamma