Steroid Injections Leading to Fractures?

A retrospective study from Henry Ford Hospital in Michigan has found that patients treated with an epidural steroid injection for back pain relief are at increased risk of bone fractures in the spine. The study, which was accepted as a Best Paper at the recent annual meeting of the North American Spine Society, involved 6,000 patients.

“For a patient population already at risk for bone fractures, steroid injections carry a greater risk than previously thought and actually pose a hazard to the bone,” said Shlomo Mandel, M.D., a Henry Ford orthopedic physician and the study’s lead author, in the October 25, 2012 news release.

Researchers say the risk of fracture increased 29% with each steroid injection, a finding they believe raises patient safety concerns. Dr. Mandel recommends that patients being treated with steroid injections be told about the risks associated with future fractures and undergo bone testing.

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.