Can My Doctor Break My Back?
Are Spinal Injections Worth The Risks?
Did you know that recent research says that spinal injections can dramatically increase your risk of a vertebral fracture?
The scary part? Over the past decade, epidural steroid injections have exploded in popularity, with over 9 million injections given every year for spinal pain! Corticosteroid injections tend to be favored over surgery by both doctors and patients (despite the lack of clinical evidence for their effectiveness and safety), but new research has shown a 21% increased risk of spinal fracture after every injection.
While therapeutic steroids may (temporarily) reduce pain, it’s now clear that the use of steroid injections promotes deterioration of skeletal quality, which is not surprising since other forms of steroid medication have long been associated with osteoporosis.
Rising Costs, Limited Benefits
What’s even more sobering is that the benefit is so minor compared to the risks. In a recent analysis of twenty-three randomized trials involving more than 2,000 patients, the effects of epidural steroid injections were compared with a placebo for the treatment of sciatica. Results showed that the epidural steroid injection produced small, insignificant short-term improvements in leg pain and disability, and this improvement only lasted two weeks to three months. Beyond twelve months, there was no significant difference between groups. Interestingly, for back pain, there was zero improvement both short- and long-term following steroid injections.
Despite this, the number of epidural injections increased 271% over the last seven years, and fees per injection have risen 100% over the last decade (after inflation). The increased rate of treatment combined with the rise in fees has resulted in a 629% jump in consumer cost for spinal injections. It all begs the question: Why such a huge increase in the use of a procedure that has limited benefit? Patients need to be informed about treatment options so they can weigh the evidence in order to make an informed decision.
Why it Matters
Spinal fractures hurt. They require further medical treatment and sometimes result in surgery. By staying conservative with your healthcare you can reduce your risks and get the relief you need. Research shows spinal adjustments are one of the best ways to reduce your pain, increase your function and improve your overall quality of life.
Injections only mask the pain temporarily.
At Ascent Chiropractic we’re focused on correcting the cause of your pain. Misalignments in your spine can put pressure on your discs and nerves causing irritation, swelling, and a loss of joint motion. A shot does not correct the cause of the pain, at best it only temporarily masks it. With the risks of spinal fractures, the smart decision is to get well and stay well using conservative, natural healthcare. In other words, you’re smart for continuing your chiropractic adjustments.
A New Approach to Low Back Pain
Today we’re seeing a quantum shift in care for back pain and sciatica patients. That shift has squarely focused on exactly what we do at Ascent Sports & Wellness Chiropractic: Establish quality movement, strengthen the supporting structures, and decrease inflammation with good nutrition.
- Establish Quality Movement: Improving joint movement is at the heart of the chiropractic adjustment. Allowing the articulations of the spinal vertebrae to move with greater efficiency while increasing neural communication is what a chiropractic adjustment provides.
- Strengthen Supporting Structures: We understand that the joint is only one component and that the muscles surrounding a joint provide a very important role. They support the joint and help to control its movement. Rehab exercises are vital to keeping the low back moving properly and staying healthy.
- Decrease Inflammation: Avoiding inflammatory foods like sugar, processed foods and alcohol can help to reduce inflammation during pain episodes. Pain intensity is often increased in those who have a high level of systemic inflammation. By eating a clean anti-inflammatory diet filled with Omega-3 fats, antioxidant rich fruits and vegetables, and foods that stabilize your blood sugar, you can reduce pain sensitivity.
- Epidural steroid injections have little clinical benefit (short or long term) and are associated with significant risks.
- Steroid injections cause deterioration of bone quality, elevating the risk of spinal fracture.
- Use of epidural steroid injections has increased dramatically despite lack of evidence to justify the procedure.
Share the science. Being well informed comes with the responsibility of sharing what you know with others who don’t. That doesn’t mean you should argue with those who are already convinced by their prejudices. It means that we encourage you to share what you know with others who are curious and can benefit from knowing the research.
Have friends or family in the Brookfield, Wauwatosa, Waukesha or New Berlin areas who could benefit from what we do at Ascent Chiropractic? We’d love to help. Call us at 262-345-4166 to set up an appointment, or use or online scheduling app.
Spinal Manipulation Postepidural Injection for Lumbar and Cervical Radiculopathy: A Retrospective Case Series. Journal of Manipulative and Physiological Therapeutics. September 2004. Volume 27. Number 7
Symptomatic MRI-Confirmed Lumbar Disk Herniation Patients: A Comparative Effectiveness Prospective Observational Study of 2 Age- and Sex-Matched Cohorts Treated with Either High-Velocity, Low Amplitude Spinal Manipulative Therapy or Imaging-Guided Lumbar Nerve Root Injections. Journal of Manipulative and Physiological Therapeutics, 2013 May; 36(4):218-25
A Retrospective Analysis of Vertebral Body Fractures Following Epidural Steroid Injections. The Journal of Bone & Joint Surgery, Volume 95, Issue 11 (2013, Jun 05;95(11):961-964)