Antibiotics could cure 40 per cent of chronic back pain

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More than 70,000 Australians could cure their chronic back pain by simply taking a course of antibiotics, new research suggests.

Danish researchers have found that many of the worst cases of chronic back pain are due to bacterial infections that could be cured with a course of antibiotics, rather than surgery.

More than 40 per cent of patients treated with antibiotics were cured from the pain. Considering hospital costs in Australia for chronic back pain and slipped discs are around $500 million a year, this could result in a huge saving.

The study examined 67 patients with chronic lower back pain following disc herniation, and confirmed five previous studies that found up to half of patients undergoing surgery for a first-time disc herniation had a bacterial infection.

Of those who tested positive for the infection, more than 80 per cent carried the microbe Propionibacterium acnes, known for causing acne.

The bacterium lives in hair roots and crevices of teeth, and can get into the blood stream during tooth brushing.

The microbe does not usually cause problems, but can if the infected person has a slipped disc. In healing the damage caused by the herniation, the body grows small blood vessels into the disc. Rather than helping, though, the blood vessels can ferry propionibacterium acnes bacteria inside the disc, where they grow and cause serious inflammation and damage to the neighbouring vertebrae.

The researchers treated patients with the common antibiotic Augmentin for 100 days, and found 80 per cent felt much less pain and took fewer sick days following treatment.

“This will not help people with normal back pain, those with acute or sub-acute pain, only those with chronic lower back pain,” lead researcher Dr Hanne Albert from the University of Southern Denmark said. “These are people who live a life on the edge because they are so handicapped with pain. We are returning them to a form of normality they would never have expected.”

Senior researcher Claus Manniche said the discovery was the culmination of 10 years’ hard work. “To find bacteria really confronts all we have thought up to this date as back pain researchers,” he said.

Dr Albert said the antibiotics would not work for all back pain, and cautioned that over-use of the drugs could lead to more antibiotic-resistant bacteria.

But, she said, many patients were undergoing ineffective surgery instead of using antibiotics that could alleviate their pain.

Dr Albert said patients who would benefit from antibiotic treatment could be identified with an MRI scan, a physical examination and pain history.

“We have to spread the word to the public, and to educate clinicians, so the right people get the right treatment, and in five years’ time are not having unnecessary surgery,” Dr Albert said.

The study has been published in the European Spine Journal.

KW