Steroid-induced Secondary Osteoporosis
While osteoporosis is the main cause of spinal compression fractures, corticosteroids can also cause your bones to weaken and become more prone to fractures.
Corticosteroids (such as Prednisone) are medications that relieve inflammation. If taken too long and at very high doses, corticosteroids can cause bone loss and osteoporosis. As such, these medications can increase your risk for developing a spinal compression fracture. (You can learn more about them in our article about corticosteroids.)
Corticosteroids work against bone health in a number of ways:
- They promote the activity of osteoclasts (which are bone-absorbing cells).
- They inhibit the formation of osteoblasts (which are bone-building cells).
- They interfere with the small intestine’s ability to absorb calcium. Corticosteroids can prevent the small intestine from absorbing the calcium your body needs, and the calcium that’s not absorbed is excreted in your urine. When your body isn’t able to absorb calcium from the small intestine, it takes calcium away from your bones. Calcium is essential to bone health, and you can learn more in our article about calcium to build bone.
Studies show that the greatest amount of bone loss occurs after the first year of corticosteroid treatment, and it’s estimated that as many as half of patients on corticosteroids will have a fracture at some point while on the medications1.
Fortunately, research has also found that patients experience a significant decline in fractures after stopping corticosteroid treatment2.
If you are taking corticosteroids and are concerned about your risk for spinal compression fractures, talk to your doctor. He or she will help you weigh the risks and benefits of corticosteroid treatment.