Back Pain Treatment Places Postmenopausal Women at Risk for Bone Loss

Postmenopausal women who were treated with an epidural steroid injection saw significant bone density loss in their hip, according to a Henry Ford Hospital study. According to the researchers, the bone density loss observed after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal woman who doesn’t receive a steroid injection.

Orthopedic surgeon and lead author, Shlomo Mandel, claims that physicians should practice caution when prescribing a steroid injection for certain patients. He suggests that multiple injections may adversely affect bone strength.

Manel states, “The findings of our study suggest that epidural steroid injections for back pain relief should be approached cautiously in patients at risk for bone fragility. Physicians who do prescribe them should consider measures that optimize bone health such as calcium andvitamin D supplements and exercise as part of their patient’s treatment plan.”

Back pain is one of the most common conditions in the US, affecting 8 out of 10 individuals at certain points throughout life. The structure of the spine must endure decades of stress, culminating in painful, degenerative changes.

Patients with back conditions are usually treated with anti-inflammatory drugs and physical therapy. If their symptoms continue, a doctor will usually prescribe an epidural steroid to alleviate pain and improve function. However, steroid use has been found to decrease the quality of bone structures.

In the observational study, researchers sought to determine whether steroid injections used for treating lumbar stenosis impacted the risk of bone loss in postmenopausal women. Lumbar stenosis is an abnormal narrowing of the spine canal. Twenty-eight patients, aged 65 and older were evaluated for bone loss using bone density testing and serum biochemical markers before receiving injections. They were tested again following three and six months.

The bone loss data was then compared to bone loss data for postmenopausal women who had never received a steroid injection. Dr. Mandel concludes, “Patients receiving multiple steroid injections with a history of steroid exposure may be especially susceptible to compromised bone strength.”

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