I was prescribed a 4mg methylprednisolone multi-day taper (MTP) pack to help deal with an injured back. However, in research I found doctors had taken advantage of anonymized electronic medical records, and found taking a single MTP increases the chances of osteonecrosis by approximately 1 in 2,000. If a second MTP is taken the chances increase to approximately 1 in 600. While the chances are very small, the consequences are rather catastrophic.
https://www.healio.com/orthopedics/journals/ortho/2014-7-37-7/%7Ba23b234a-a94f-4173-8bb6-9abad2b69aa7%7D/osteonecrosis-following-short-term-low-dose-oral-corticosteroids-a-population-based-study-of-24-million-patients
However, there is research which suggest vitamin E can help prevent osteonecrosis when taking steroids. Since there's no downside to taking vitamin E, I took it daily both before and after the MTP, and took close to the maximum dose while taking the MTP.
http://www.sciencedirect.com/science/article/pii/S2214031X14002575
