Oral corticosteroids and treatment of National Football League players: a survey of team physicians

Purpose of review: Oral corticosteroids are used frequently in the treatment of musculoskeletal injuries without a solid evidence-based indication or specific guidance on dose and duration of therapy. The use of oral corticosteroids in sports medicine is based on their strong antiinflammatory properties. The purpose of this study was to gain insight into how the team physicians for the National Football League use oral corticosteroids in the care of professional football players. Recent findings: Of the team physicians surveyed, 83.9% occasionally prescribe oral corticosteroids in their general practice, and the same percentage occasionally prescribe oral corticosteroids in treating professional football players. The most common indication for the use of oral corticosteroid therapy by the team physicians is intervertebral disc herniations. The most common oral corticosteroid used was methylprednisolone at a starting dose of 12–24 mg (61.3%), and the most common duration of therapy selected was 7 days (77.4%). Of the team physicians, 25.8% reported that they have observed a serious complication in their careers, and most these complications were avascular necrosis. Of the team physicians surveyed, 90.3% stated that their opinion of the short-term use of oral corticosteroids in elite athletes is safe and effective. Summary: This survey perhaps allows a starting point for further research with which we may begin to formulate a safety profile to assist team physicians on the use of these drugs and be better able to educate the athletes whom we treat on the relative risk of this class of medications. Prospective studies are needed to more adequately evaluate the efficacy and safety of these agents.