Also Included In: Bones / Orthopedics
Article Date: 26 Oct 2012 - 2:00 PDT
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Link Between Steroid Injection And Increased Risk Of Bone Fractures
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Patients treated with an epidural steroid injection for back pain relief are at increased risk of bone fractures in the spine, according to a Henry Ford Hospital study.
Researchers say the risk of fracture increased 29 percent with each steroid injection, a finding they believe raises patient safety concerns.
"For a patient population already at risk for bone fractures, steroid injections carry a greater risk that previously thought and actually pose a hazard to the bone," says Shlomo Mandel, M.D., a Henry Ford orthopedic physician and the study's lead author.
Dr. Mandel recommends that patients being treated with steroid injections be told about the risks associated with future fractures and undergo bone testing.
The study was accepted as a Best Paper presented at the annual meeting of the North American Spine Society in Dallas.
Bone fractures in the spine are the most common fracture in patients with osteoporosis, affecting an estimated 750,000 people annually. Roughly 40 percent of women aged 80 and older experience bone fractures in the spine.
Patients are typically treated with anti-inflammatory drugs and physical therapy. If symptoms persist, an epidural steroid is often prescribed to alleviate pain and improve function. However, steroid use has been linked to diminished bone quality.
In a retrospective study, researchers compared data of 6,000 patients treated for back pain between 2007 and 2010 - 3,000 patients who received at least one steroid injection and 3,000 patients who did not receive injection. The average age of patients was 66 years, and 3,840 were women and 2,160 were men. Researchers also analyzed the incidence of bone fractures in each group. Using the survival analysis technique, researchers found that the number of steroid injections is linked with an increased likelihood of fracture.
Visit our back pain section for the latest news on this subject.
Henry Ford did not use the steroid injection medication at the center of the meningitis outbreak.
Henry Ford Health System
MLA
n.p. "Link Between Steroid Injection And Increased Risk Of Bone Fractures." Medical News Today. MediLexicon, Intl., 26 Oct. 2012. Web.
19 Dec. 2012. <http://www.medicalnewstoday.com/releases/252013.php>
APA
http://www.medicalnewstoday.com/releases/252013.php.
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Visitor Opinions (latest shown first)
alternatives for patients - re steroids and bone fracture risk
posted by Dr. Steven Struhl M.D. on 27 Nov 2012 at 4:57 pmThere has to be better alternatives for patients being treated with epidural steroid therapy. Especially if some or majority are older people being treated for osteoporosis. There is no point in alleviating pain and improving function if it means diminishing your bone quality in the process.
Long Term Morphine V. Epidural
posted by trey barber on 27 Oct 2012 at 3:08 pmThis is another study demonstrating that an epidural to treat back pain has more detrimental side effects than using opiates as part of overall pain management strategy. Good luck in finding a pain treatment that works for you
Have Patience
posted by Bill Yancey on 27 Oct 2012 at 5:43 amA lot of unnecessary low back pain treatment happens because patients are not patient. They expect an instant cure, pill or injection. Unfortunately, the medical system in the US has become a big business and is more interested in making money than telling patients what they really need to know. Back pain is common. The treatment for acute back pain is as follows:
First, your back needs a period of rest. A short period of bed rest is in order.
Second, get some pain relief with an over-the-counter medication.
Third, place some ice on the areas that hurt.
Fourth, after the bed rest and pain medicine have begun to give you some pain relief, and as soon as you notice any improvement, get moving.
Fifth, address muscle spasm with rest, massage, and/or heat.
Sixth, give your body a chance to heal. Takes 2-12 weeks.
Seventh, gradually resume normal activities.
Eighth, gradually strengthen your back. Some exercises will make it better; some will make it worse. Find out which are which. Don't start them, yet. You have a couple weeks to figure out the difference.
Ninth, eventually increase flexibility once the pain has resolved. Don’t overdo it.
IF there is no improvement after two months, or there are progressive neurological deficits or intractable pain, then other treatments MAY be warranted. Steroid injections are statistically no better than other forms of placebos, such as:
1. Any form of traction, including VAX-D, DRS, DRX, Inversion Therapy, Lordex, etc.
2. Trigger point injections.
3. Facet injections.
4. Sacro-iliac injections.
5. Acupuncture
6. Paleo (or any other fad) diet
7. Magnetic Therapy (of any type)
8. Prolotherapy
9. Reflexology
10. Over the counter nutritional supplements
11. Qigong
12. Cupping
Surgery is not indicated in 90-95% of cases. The surgeon needs to make a real case that he understands the cause of the pain and that the pain will go away with the surgery. There is a lot more info on my blog if you are interested.
Bill Yancey, MD
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