The recent meningitis outbreak has caused a lot of attention to be given to the use of steroid injections for lower back pain management. Aside from concerns about insufficient regulation of compounding pharmacies like the one that distributed the tainted steroid, complaints from health professionals and researchers about the overuse of this unproven method of treatment have also been sounding loud. Epidural steroid injections are generally seen as a short-term, unreliable method of back pain management.
There may be more concerns associated with these injections that have not been made public knowledge. For example, oral and intravenous steroids have long been associated with bone loss, but it wasn’t until recently that a link was established between injected steroids and bone loss. Researchers from the Henry Ford Hospital presented findings of a study they conducted to the North American Spine Society in Dallas this October which establish such a connection.
Osteoporosis, a disease characterized by the loss of bone density, commonly leads to bone fractures. Spinal fractures are the most common type among those with osteoporosis. The disease generally affects men and women over 50, and women are 4 times more likely to be affected. According to the American College of Rheumatology, osteoporosis-related fractures will affect 1 in 2 women over the age of 50 and 1 in 6 men.
Henry Ford Hospital researchers reviewed data for 6,000 patients treated for lower back pain between 2007 and 2010; half of the patients had received at least one steroid injection, and the other half received none. They found that the likelihood of incurring a bone fracture increased 29% for each injection received. More on the study can be my sources.
This study is in its preliminary stages as it has not gone through the peer-review process yet. Its results still give cause for concern among both health professionals and patients over 50 with lower back pain. The study is relatively short-term, establishing a link between injections received among older patients and bone fractures incurred within a few years of having an injection. More studies are needed to consider a possible link between lifelong steroid injection use and the risk of bone fractures later in life.
While it is true that this study has not yet been subjected to the rigorous peer-review process that would render its findings officially valid, it at the very least merits the issuing of a warning to patients over 50 with back pain. Knowing that there is a possible association between the injection and bone fractures may be enough to motivate back pain patients to seek other, less risky forms of treatment.