Antibiotics May Relieve Chronic Lower Back Pain Cases

As many as four in 10 cases of chronic lower back pain are probably caused by bacteria, and treatment with antibiotics may cure them, a study showed.

As many as 80 percent of the participants with persistent back pain following a herniated disc and swelling in the spine reported an improvement after taking antibiotics three times daily for 100 days, Danish scientists wrote in research published by the European Spine Journal.

“In people who received the placebo, nothing happened,” Hanne B. Albert, an associate professor at the University of Southern Denmark who led the research, said today at a press conference in London. “People on the antibiotics attained highly clinically significant improvement.”

The findings support previous research that has linked some cases of chronic back pain to bacterial infection. The team of scientists said the discovery merits the establishment of a new disease category, Modic-related low back pain. The group devised a diagnostic test using MRI scanning and treatment with Bioclavid, a generic version of GlaxoSmithKline Plc’s Augmentin.

The pain is caused by an infection of Proprione acne bacteria inside the affected spinal disc, Albert said. The bacteria normally live in hair follicles, on the gums and inside cheeks and may enter the bloodstream after the teeth are brushed and travel into the damaged disc, she said.

Antibiotic Effect?

Patients in the trial who were prescribed the antibiotic were better able to function after one year and they had less lower back pain, less leg pain and fewer days off work due to the condition than those on the placebo, according to study.

Albert said that the antibiotic regimen is not appropriate for everyone with lower back pain and that it shouldn’t be given to patients for whom it isn’t suitable or who are allergic to antibiotics. People who do undergo the treatment aren’t more susceptible to developing antibiotic resistance because the infection occurs within the spinal disc and the condition isn’t contagious, Albert said.

The researchers studied 162 people who had pain for more than six months after a herniated disc and had bone swelling known as Modic Type 1 changes. Four patients stopped treatment, mainly because of gastrointestinal side effects. More studies should be conducted in other types of patients and to better understand the science underlying the disease and its treatment, Albert’s team said.

The study was funded by six Danish foundations and the Danish Rheumatism Association. Modic Type 1 accounts for as many as 40 percent of chronic back-pain cases, according to the report.

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