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Bone Fracture Risk Associated With Steroid Injections



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Back pain is a very common ailment suffered by a large number of people in the US and elsewhere around the world. Hectic lifestyle, improper posture, and improper shoes all lead to back pain. According to studies, nearly 80% of all Americans face back pain once in their lifetime. It is the topmost reason for absence from work. Although it may affect any age, it is more prevalent amongst adults between the ages of 35 to 55 years.  Due to its high prevalence, numerous studies have been carried out to find a suitable cure for back pain. Right from medications to surgeries, various methods have been developed to cure backache.

Risk Factors of Back Pain

There are many factors which can trigger back pain, such as:

Steroid Injections for Back Pain

As mentioned earlier, there are many cures available for back pain; many new studies to are being carried out to determine effective ways to treat back pain. One such treatment is the steroid injection for back pain relief. These injections are administered in the same spot as an epidural, and 2 or 3 shots are given over a few months. The course is usually determined depending upon the severity of pain. Most patients require more than one shot to subside the pain.

The steroid injections have been used for back pain since 1952 and are an integral part of non- surgical treatment for sciatica and low back pain. Although the aim of the injection is to provide relief from pain, it is often used in conjunction with a rehabilitation program in order to promote overall health.

Benefits of Steroid Injections

  • Delivers the drug on-site of pain, unlike painkillers which disperse throughout the body and have slow effects.
  • Most pain stems from inflammation, steroid injection helps alleviate the same.
  • It is non-operative, thus there are no post-operation complications.
  • It is an outpatient procedure and thus patients can return to normal work the next day.

Associated Risk

Although steroid injections are very effective, there are many risks associated with the treatment. Researchers are of the opinion that the risk of fracture increases by 29% after every shot of steroid injection. This therefore greatly affects the safety of the patient.

Dr. Sholomo Mandel, M.D, an orthopedic surgeon and lead author of a study on steroid injections, is of the opinion that the population in America is already at risk of bone fracture, steroid injections further add to the risk and pose a danger to the bone. Doctors and researchers also believe that the associated fracture risk should be made aware of the patient prior to the administration of the injection.

This study paper on the associated fracture risk due to the use of steroid injections was accepted as the Best Paper at the North American Spine Society at Dallas.

Estimates suggest that bone fractures of the spine are the most common in patients suffering from osteoporosis. Nearly 750,000 people are affected annually by this condition. Patients are first treated with physical therapy and anti-inflammatory drugs, but when the pain persists, a steroid injection is administered to alleviate pain; however, this use of steroid injection considerably reduces bone quality.

The above hypothesis was established by undertaking a study; wherein data of 6000 patients treated for back pain between the years 2007 to 2010 were compared. 3000 patients had received steroid injection at least once during their treatment period whereas the other 3000 had not. The average age of patients was 66 years, 3840 were women whereas 2160 were men. The prevalence of bone fracture was analyzed in each group. Upon research using the survival analysis technique, it was revealed that there was an increased likelihood of fracture amongst those who had received steroid injections, thus confirming the associated risk of steroid injections for backache.

Every treatment has its own share of benefits and side effects, it is, therefore, imperative to indulge in a dialogue with your general practitioner before administration of steroid injections.