According to suggestion of one new study, adults who are older and get steroid injections for lowering leg and back pain might have higher odds of suffering spine fracture.
It is not clear, though, whether treatment should be blames, the experts say. They do say that the findings that got published in Journal of Bone and Joint Surgery on June 5, suggest that the older patients who have low density of bones should remain cautious regarding the steroid injections.
This treatment involves injection of HGH for men which are anti-inflammatory in the area of spine where one nerve is compresses. Source of such compression can be some herniated disc, or some spinal stenosis, one condition in old adults where open spaces within spinal cord narrow gradually.
These injections are capable of bringing pain relief temporarily but it is known that the steroids could cause density of bones to decrease with the passage of time. A study lately showed that older women who are given steroids to combat pain related to spine demonstrate quicker bone loss rate compared other women of their age.
Latest findings go one step ahead by showing increased risk of fracture in the steroid patients, according to lead researcher over both studies, Dr. Shlomo Mandel. He said that this medical-record based study had many limitations. He also said that he wanted to be pretty careful not to mean that the people should not get those injections.
These findings are mainly based over medical records that are from three thousand patients of Henry Ford and were getting steroid injections to kill pain related to spine, and another three thousand getting other treatments. On average, they were sixty-six years old.
Overall, around 150 patients later were diagnosed with vertebral fracture, according to Mandel.At an average, it was found by Mandel’s team that at quite a risk of vertebral fracture were the patients with steroid patients, with risk increasing 21% with every injection’s round.
These findings don’t prove that injections cause fractures, according to Dr. Andrew Schoenfeld, who was the one to write commentary which published with study, but results do raise important risk which has to be measured against benefits. He says that it brings in to light what should be the part of discussions between a doctor and patient.
However, he cautioned that findings might apply to only specific patients, namely the older adults who have waning mass of bones. He said that it is not known if that would apply even to the elderly people who have normal mass of bones.
He told that steroid injections do seem to be of use in only some types of pain related to spine. The ideal medical evidence which they work tends to be for cases like of leg pain that is caused by herniated disc as it compresses a nerve.
Discussing spinal stenosis, steroid injections could help in cramping and leg pain but there’s little evidence that these injections lower the pain which is concentrated in low back, he said.
If that is the basic problem for older adult, side effect, though potential, of one vertebral fracture can outweigh any little benefit chance.
The epidural steroids are having negative press lately. Currently the US officials are investigating an outbreak of the fungal meningitis which is deadly and linked to the epidural steroids that are produced by a Massachusetts pharmacy. One study that was released in the month of March showed steroid injections are much less effective in relieving the back pain as compared to surgery or other treatments.
Mandel and Schoenfeld said that this treatment has still got some role to treat certain pain related to spine. According to them, the old patients who already have found relief of leg-pain from the steroid injections might want to be stuck with them. Still, they should be aware of potential risk of fracture, at least.
If they choose to continue on with treatment, they might want to discuss with the doctors the ways of preserving bone mass, like vitamin D and calcium supplements.
Schoenfeld said that there were many options for the spinal stenosis also: the doctors normally start conservatively, suggesting medication and physical therapy.
He further says that the steroid injections will serve as middle ground especially for patients who do not respond to such treatments but like to put the surgery off. Lastly, according to him, surgery for relieving pressure on nerves in mostly effective though someone who has spinal stenosis might develop narrowing in some other area of the spine later.