Statin Use Could Be Associated With Higher Risk of Back Disorders

A cohort study of TRICARE patients found that those who began to use statins were more likely to be diagnosed with a back disorder.

The research, published in JAMA Internal Medicine, reviewed healthcare records for more than 60,000 patients enrolled in TRICARE, the Department of Defense’s healthcare system for members of the military and their families. Patients were followed from October 2003 to March 2012 to create 2 groups: first-time statin users who continued use for 120 days or more, and nonusers defined as those who had never been prescribed statins and the statin users before they were prescribed statins.

Using propensity score matching, the researchers matched 6728 of the statin users to the same number of nonusers with similar baseline characteristics, including healthcare utilization, comorbid conditions, and other medication use. Almost three-fourths of the prescriptions received by the statin users were for simvastatin, which is used to lower lipid levels.

The statin users were significantly more likely to have been diagnosed with a back disorder, such as spondylosis or intervertebral disc disorders, than the nonusers (odds ratio, 1.27). Secondary analyses revealed that longer duration and higher dose of statin use were associated with even higher risk of a back disorder diagnosis.

As statins are thought to contribute to muscle pain that can manifest in the back, some previous studies have investigated the potential link between statin use and back pain and found that back pain was more prevalent in statin users. However, according to the authors of the new research, “this study is the first to report greater odds of back disorders among statin users compared with the odds of nonusers in a population with equal access to and the same cost of healthcare.”

The researchers noted that the uniqueness of this population may limit the generalizability of the study findings, as it is unclear whether the patterns would persist in “more sedentary” populations or people not associated with the military. The study population was also relatively young, with a mean age of 46.6 years.

Despite the limitations of the retrospective study, the researchers wrote that its findings indicate the need for more research on statin use and muscular pain, “specifically if prescribed for primary prevention in physically active individuals.”

The study was published around the same time as another study in The Lancet that showed patients were more likely to report muscle pain if they knew they were taking statins, but for those who were unaware, there was no increase in muscle-related complaints. The “nocebo” effect observed adds another layer of complication to the debate surrounding the adverse events associated with statins and the balance of risks and benefits for patients seeking to manage their lipid levels.