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Will epidural spinal injection weaken my spine more?

Posted by dappy @dappy, Jan 29, 2022

My MRI shows 2 bulging discs, a disc fissure (?) and mild spinal stenosis. I will meet with my dr. this week and was wondering if he suggests an epidural spinal injection will it weaken the osteoporosis already in my spine? That’s my fear!
Also, would PT or chiropractor help with these problems? My pain is mostly daily but only occasionally does it make me to where I can’t do my regular routine. Any input is appreciated! Thanks!

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Moderator
Colleen Young, Connect Director | @colleenyoung | Jan 30, 2022

@dappy, Studies have suggested that epidural shots may increase the risk of spinal bone fractures, and researchers say patients with bone loss should be warned about this risk.

- Use Epidural Steroid Injections Cautiously in Patients with Fracture Risk https://www.the-rheumatologist.org/article/use-epidural-steroid-injections-cautiously-patients-fracture-risk/

So your question is a very good one to discuss with your doctor at your upcoming appointment. I think you should also ask about PT and chiropractic therapy if they would be helpful in your case. The physical therapist can also be very helpful in suggesting daily exercises that might be helpful.

As you prepare for your upcoming appointment, you might also appreciate these past discussions:

- Spinal epidurals: https://connect.mayoclinic.org/discussion/spinal-epidurals/
- Spinal Stenosis & Degenerative Discs: Long-term use of epidurals: https://connect.mayoclinic.org/discussion/new-to-chronic-pain-discussion-board/

REPLY
1 reply
dappy | @dappy | Jan 30, 2022
In reply to @colleenyoung "@dappy, Studies have suggested that epidural shots may increase the risk of spinal bone fractures, and..." + (show)
@colleenyoung

@dappy, Studies have suggested that epidural shots may increase the risk of spinal bone fractures, and researchers say patients with bone loss should be warned about this risk.

- Use Epidural Steroid Injections Cautiously in Patients with Fracture Risk https://www.the-rheumatologist.org/article/use-epidural-steroid-injections-cautiously-patients-fracture-risk/

So your question is a very good one to discuss with your doctor at your upcoming appointment. I think you should also ask about PT and chiropractic therapy if they would be helpful in your case. The physical therapist can also be very helpful in suggesting daily exercises that might be helpful.

As you prepare for your upcoming appointment, you might also appreciate these past discussions:

- Spinal epidurals: https://connect.mayoclinic.org/discussion/spinal-epidurals/
- Spinal Stenosis & Degenerative Discs: Long-term use of epidurals: https://connect.mayoclinic.org/discussion/new-to-chronic-pain-discussion-board/

Jump to this post

Thank you so much @colleenyoung. I did ask the dr. at the last appt. when he mentioned it as a possibility. He said it should not be a problem- only if I was to get multiple injections in a short span of time. I will look at the discussions you mentioned. I am very fearful of a fracture in my spine with the osteoporosis.

REPLY
1 reply
Mentor
Jennifer, Volunteer Mentor | @jenniferhunter | Jan 30, 2022
In reply to @dappy "Thank you so much @colleenyoung. I did ask the dr. at the last appt. when he..." + (show)
@dappy

Thank you so much @colleenyoung. I did ask the dr. at the last appt. when he mentioned it as a possibility. He said it should not be a problem- only if I was to get multiple injections in a short span of time. I will look at the discussions you mentioned. I am very fearful of a fracture in my spine with the osteoporosis.

Jump to this post

@dappy I want to add some more to Colleen's post. I found several links about steroid injections with osteoporosis and one is a Mayo News Network story.
https://pubmed.ncbi.nlm.nih.gov/29304236/
https://journals.lww.com/md-journal/fulltext/2019/06280/effect_of_medications_and_epidural_steroid.30.aspx
https://www.spineuniverse.com/professional/news/osteoporosis/epidural-steroid-injections-osteoporotic-fracture-risk
https://newsnetwork.mayoclinic.org/discussion/occasional-cortisone-injections-unlikely-to-have-negative-affect-on-bones/
I understand your concerns about osteoporosis and spine fracture. That has happened to my elderly mom with a spine compression fracture, and she is now undergoing injections of Evenity because she has severe osteoporosis. You may want to consider a consult with an endocrinologist to make sure that you are getting good treatment for building bone. It can be a complex problem, and my mom had exacerbation of thinning bones because of a problem with parathyroid glands that were pulling calcium out of her bones, so the damage was done, and it is hard to try to catch up at her age. The endocrinologist specialist will understand the complex issues that can affect bone quality. Bone quality is important for spine surgery that could be in the future. Sometimes spinal hardware is screwed into the bone, and it is possible for screws to pull out or migrate if there is poor bone quality. That could affect what procedure a surgeon can do with these risks. My mom had been under the care of her primary care physician for years, but they didn't understand the complexity involving the parathyroid disease with the drugs prescribed for bone building.

I am a spine surgery patient and I have had a cervical epidural injection that I had a bad reaction to. It caused me to have stabbing burning nerve pain for several weeks in my hand and nerve sensitivity for a year and a half. It has some real risks, so make sure they are explained to you if you are considering an injection. It won't fix anything, but it can reduce pain by reducing inflammation. Doctors sometimes use these injections to postpone surgery.

I would also recommend discussing any possible chiropractic treatment with your spine specialist. If you have a bulging disc, it can be very easy to rupture it with a forceful chiropractic maneuver. I ruptured a disc in my neck simply by turning my head, and herd a pop and my head suddenly turn further. It didn't hurt, but it felt weird and it then caused bone spurs to grow because of the inflammation from the jelly like disc material that was extruded.

My physical therapist was very beneficial in buying me time and reducing pain by gently keeping my neck aligned. She also was using a Dolphin Neurostimulator that would inhibit the neurotransmitters for the pain impulses and it reduced pain for about a week. I was working with a PT for the 2 years before my spine surgery and it helped a lot.

Are you currently undergoing treatment for your osteoporosis?

REPLY
1 reply
dappy | @dappy | Feb 2, 2022
In reply to @jenniferhunter "@dappy I want to add some more to Colleen's post. I found several links about steroid..." + (show)
@jenniferhunter

@dappy I want to add some more to Colleen's post. I found several links about steroid injections with osteoporosis and one is a Mayo News Network story.
https://pubmed.ncbi.nlm.nih.gov/29304236/
https://journals.lww.com/md-journal/fulltext/2019/06280/effect_of_medications_and_epidural_steroid.30.aspx
https://www.spineuniverse.com/professional/news/osteoporosis/epidural-steroid-injections-osteoporotic-fracture-risk
https://newsnetwork.mayoclinic.org/discussion/occasional-cortisone-injections-unlikely-to-have-negative-affect-on-bones/
I understand your concerns about osteoporosis and spine fracture. That has happened to my elderly mom with a spine compression fracture, and she is now undergoing injections of Evenity because she has severe osteoporosis. You may want to consider a consult with an endocrinologist to make sure that you are getting good treatment for building bone. It can be a complex problem, and my mom had exacerbation of thinning bones because of a problem with parathyroid glands that were pulling calcium out of her bones, so the damage was done, and it is hard to try to catch up at her age. The endocrinologist specialist will understand the complex issues that can affect bone quality. Bone quality is important for spine surgery that could be in the future. Sometimes spinal hardware is screwed into the bone, and it is possible for screws to pull out or migrate if there is poor bone quality. That could affect what procedure a surgeon can do with these risks. My mom had been under the care of her primary care physician for years, but they didn't understand the complexity involving the parathyroid disease with the drugs prescribed for bone building.

I am a spine surgery patient and I have had a cervical epidural injection that I had a bad reaction to. It caused me to have stabbing burning nerve pain for several weeks in my hand and nerve sensitivity for a year and a half. It has some real risks, so make sure they are explained to you if you are considering an injection. It won't fix anything, but it can reduce pain by reducing inflammation. Doctors sometimes use these injections to postpone surgery.

I would also recommend discussing any possible chiropractic treatment with your spine specialist. If you have a bulging disc, it can be very easy to rupture it with a forceful chiropractic maneuver. I ruptured a disc in my neck simply by turning my head, and herd a pop and my head suddenly turn further. It didn't hurt, but it felt weird and it then caused bone spurs to grow because of the inflammation from the jelly like disc material that was extruded.

My physical therapist was very beneficial in buying me time and reducing pain by gently keeping my neck aligned. She also was using a Dolphin Neurostimulator that would inhibit the neurotransmitters for the pain impulses and it reduced pain for about a week. I was working with a PT for the 2 years before my spine surgery and it helped a lot.

Are you currently undergoing treatment for your osteoporosis?

Jump to this post

I was on Prolia and stopped it but went on Actonel. My T score in spine is -3.2.

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