Cortisone and Osteoporosis

 

Research now shows a negative relationship has been seen between cortisone and osteoporosis.

Cortisone and Osteoporosis. Photo Credit: Wikipedia

Cortisone and Osteoporosis. Photo Credit: Wikipedia

Of all pain diagnosis in the United States, low back pain is the most common. Low back pain affects 8 out of 10 individuals at some point during life. From athletics to elderly and deconditioned individuals back pain is common to all populations. Often as a result of the pain/discomfort individuals compensate through changes in normal locomotion and biomechanics, which can accelerate degenerative changes in the spine. Individuals are typically treated with anti-inflammatory over-the-counter medication and physical therapy. If pain persists, an epidural steroid commonly called cortisone is often prescribed to alleviate pain and improve function. However, cortisone use has been linked to diminished bone quality.

What is Cortisone?

Cortisone is a steroid normally produced by the adrenal gland. Pharmaceutical companies have been synthesizing hormone for clinical use. Cortisone is used to treat lupus, multiple sclerosis, chronic obstructive pulmonary disease, as well as joint and back pain. It is even prescribed to prevent rejection of transplanted organs.

Cortisone and Osteoporosis

A sample of patients treated at the Henry Ford Hospital showed those who received injected cortisone found that a single shot into the spine for back pain reduced bone mass density of the hip. The observational study sought to evaluate whether cortisone injections used for treating back pain, increased the risk of bone mass density loss in postmenopausal women. Twenty-eight patients, aged 65 and over, were screened for bone loss using DXA scans and blood tests that show bone health markers prior to receiving an injection, then at three months, and again at six months. The bone loss data was compared to bone loss data for postmenopausal women who hadn’t been treated with a cortisone injection.

The bone mass density decrease after six months was six times greater when compared to the typical bone density loss seen in a year in a postmenopausal female who did not receive a cortisone injection (Henry Ford Health System, 2012).  Shlomo Mandel, M.D a Henry Ford Hospital orthopedic physician also the study’s lead author, states that physicians should cautiously prescribe epidural cortisone injections for select patients, emphasizing that multiple injections of cortisone might even accelerate the loss in bone density showing a relationship between cortisone and osteoporosis.

Earlier attempts to identify the relationship between bone density loss and cortisone produced contradictory results. In lab animal experiments, researchers saw cortisone caused osteoblast (bone creation cells) to self-destruct, suggesting that cortisone limits the body from creating new bone. This is in contrast to test tube experiments that showed cortisone initiating bone formation. This confused researchers; however now more research such as the above is being completed showing injected cortisone being a medication that damages bone.

 

 

Reference:

Henry Ford Health System (2012, December 1). Steroid injection linked with significant bone loss in postmenopausal women treated for back pain. ScienceDaily. Retrieved March 19, 2013, from http://www.sciencedaily.com­ /releases/2012/12/121201085911.htm

 

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