Antibiotics likely to cure 40% of chronic back pain patients, says study
According to a new study published in the European Spine Journal, antibiotics rather than surgery could cure many patients with chronic lower back pain.
The Danish study reveals the breakthrough that could save hospital costs to treat back pain and slipped disks tp as mych as US$500 million a year.
An earlier interview of Australian Journalist Alison Caldwell with Peter Wilde, an orthopaedic surgeon and President the Spine Society of Australia confirms that about 40% of the cases undergo surgery. Caldwell expounds on the Danish study, which examined 67 patients with chronic lower back pain, following disc herniation. The average age was 46 and 27% of the patients were women.
He says the study confirms the findings of five previous studies which suggested that up to half of patients undergoing surgery for a first-time disc herniation have a bacterial infection. Of those who tested positive, more than 80% carried bugs called Propionibacterium acnes, or microbes better known for causing acne.
They live in hair roots and the crevices of teeth and can get into the bloodstream during tooth brushing. They don’t usually cause any trouble but they might when a person suffers a slipped disc.
The findings mean that scores of patients with unrelenting lower back pain may no longer have to face major operations but can instead be cured with a course of antibiotics over 100 days.
”The publication talks specifically about MRI changes that occur in adjacent vertebral disks after a patient has a lumbar discectomy. Now a lumbar discectomy is an operation which is done for a disk prolapse and for many years when surgeons have sent specimens to laboratories, a certain percentage of patients will grow a bacteria. And for many years surgeons have just put that down to contamination, “ Wilde says.
”This group has documented vary carefully that in these patients they often get changes at the next disk, which means either one disk above or below, of changes which are quite curious on the MRI scan and that’s referred to as a Modic one change and the contention that they putting is that these changes actually occur because of the bacterial infection and possibly this group if we could identify the group would respond to a regime of antibiotics. “he adds.
Caldwell cites an author, Dr Hanne Albert from the University of Southern Denmark, who said the study would not help people with normal back pain or those with acute or subacute pain, only those with chronic lower back pain. She says with a course of antibiotics these people are being returned to a form of normality they would never have expected.
To that, Wilde says that more research is needed, adding that he “suspect(s) that if bacteria do cause back pain it’s only in a very small percentage of some patients and the next challenge if it is in fact true is to identify which back pain patients might be due to a bacterial infection and obviously if we can demonstrate that then antibiotics might help those patients.”
Caldwell also quotes Dr Hanne Albert regarding the subgroup of patients who would benefit from the antibiotic treatment could be identified with an MRI scan, a physical examination and pain history. The people have chronic lower back pain and suffer from constant pain 24 hours a day, seven days a week.
The study has been published in the European Spine Journal.
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