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Back Pain Health Center

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Back Pain? Steroid Shots May Raise Fracture Risk

WebMD Health News
Reviewed by Louise Chang, MD

Oct. 25, 2012 -- Steroid injections to the spine were widely considered to be safe before being linked to an outbreak of fungal meningitis that by mid-week had killed 24 people in 17 states.

But a study out today raises new concerns about the injections that are used to treat millions of back pain sufferers every year -- and it has nothing to do with the tainted steroids blamed for the meningitis outbreak.

Spine Injections May Raise Fracture Risk

Epidural steroid shots are injected into the space around the spinal cord. The steroid works to curb inflammation in the area, leading to pain relief.

The study suggests that epidural shots increase the risk of spinal bone fractures, and researchers say patients with bone loss should be warned about this risk.

The research was presented today in Dallas at the annual meeting of the North American Spine Society.

Bone fractures of the spine are the most common fractures in patients with osteoporosis.

According to the American College of Rheumatology, one in two women over 50 and one in six men will suffer a fracture related to osteoporosis.

“For a patient population already at risk for bone fractures, steroid injections carry a greater risk than previously thought,” says researcher Shalom Mandel, MD, of Henry Ford Hospital in Detroit.

While other steroid treatments, such as those taken orally or by IV, have long been linked to bone loss, epidural steroid shots are thought to have little impact on bones because they are delivered directly to the problem area and believed to have less effect on the rest of the body.

But Mandel says this may not be the case.

“If epidural steroids are causing fractures, it is probably because the treatment is not localized,” he says. “The drug may be entering the circulatory system.”

More Study Needed, Doctor Says

The Henry Ford Hospital researchers examined data on 6,000 patients treated for back pain between 2007 and 2010.

Half the patients were treated with at least one epidural steroid shot and the other half had never had the treatment.

According to the analysis, spinal fracture risk increased by 29% with each steroid shot. This was an association though, and does not prove cause and effect.

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