# Thoracic Intervertebral Disc Herniation Associated With Chronic Anabolic Androgenic Steroid Use: A Case Report

## TL;DR

A bodybuilder's long-term use of anabolic steroids led to a severe spinal disc herniation, highlighting a serious but under-recognized health risk.

## Contribution

This case report is the first to link chronic anabolic steroid use with thoracic disc herniation requiring surgical intervention.

## Key findings

- Chronic AAS use was associated with thoracic disc herniation requiring decompression and fusion.
- Literature review suggests AAS may weaken connective tissues and increase injury risk during weight-bearing exercise.
- Case highlights the need for awareness of spinal risks in long-term AAS users.

## Abstract

Anabolic androgenic steroids (AAS) are relatively cheap and accessible medications, commonly used by athletes and bodybuilders for performance enhancement and muscle growth stimulation. AAS usage has been associated with musculoskeletal injuries, such as tendon and ligament ruptures, and numerous other detrimental health effects. Despite these risks, individuals continue to self-administer these drugs in supraphysiologic doses. Here, we present a case of a male bodybuilder with chronic AAS use who developed a spinal thoracic intervertebral disc herniation requiring decompression and fusion. We use this case to highlight a severe potential risk associated with chronic AAS abuse and review the current literature on the biochemical, physical, and physiologic mechanisms linking chronic AAS use, weight-bearing exercise, and the risk of musculoskeletal injuries such as intervertebral disc herniations.