@mnsansei Not mnsansei here, but EXCESSIVE use of oral or injected steroids (like cortisone or prednisone) MAY cause osteoporosis in some individuals. The risk all depends on the person, the dosage, the frequency, and to some extent, the expertise of the person giving the injections.

In my case, periodic cortisone injections for severe joint inflammation and oral prednisone for asthma and inflammation have been part of my life for over 30 years. My doctors are careful to use it only when really needed. I am female, over 70, with a small frame and a family history of osteoporosis, but as of my last DEXA scan, I have not developed osteoporosis or osteopenia.

So, as with all medications, the risks and benefits must be carefully weighed. My orthopedic doctor and I just discussed this very issue yesterday, as disk degeneration is leading to a decision point - do I live with debilitating pain, have spinal surgery that often is only successful for a few years, or treat with x-ray guided, targeted cortisone injections? Based on his expert recommendation and my experience, I am likely to try the injections first.