Corticosteroids are possibly the most important drug in managing rheumatic diseases, especially during acute flares, but their long-term use carries significant risks. When adequate response has been achieved, other drugs must be employed. Chronic management on corticosteroids and not as bridging therapy can result in adverse effects, including osteoporosis, diabetes, hypertension, weight gain, infections and adrenal insufficiency. On the other hand, inadequate dosing during acute flares can lead to irreversible organ damage, while improper tapering augments the risk for disease relapse. Intramuscular or depot corticosteroids pose unique challenges, including prolonged systemic exposure and limited flexibility in tapering. Generally speaking, corticosteroids are often overused where steroid-sparing therapies such as disease-modifying anti-rheumatic drugs should be prioritised in cases where no contraindication exists. An effective strategy should include early initiation of alternative therapies, gradual corticosteroid sparing and continuous monitoring of side effects. By applying this strategy, corticosteroid exposure is minimal, and clinicians can improve patient outcomes, minimising treatment-related complications.