Several decades ago, the bacterium – Helicobacter pylori, was theorized as the cause of gastritis and ulcers. The researchers were initially ridiculed until further studies proved they were right. Now, a course of antibiotics is often used to treat these diseases. This week, researchers from Denmark proposed a similar concept for a different disease. Bacteria may be the cause of back pain in many individuals with herniated discs.
In this year’s April issue of the European Spine Journal, two studies showed that bacteria may be the cause of back pain and that antibiotics may be curative. In the first study, researchers found the bacterium, Propionibacterium acnes, in 43% of patients undergoing surgery for lumbar disc herniation. Those with bacteria within their discs more frequently had specific changes on magnetic resonance imaging/MRI termed Mobic I changes. In the second study, researchers enrolled 162 individuals with chronic low back pain, a prior disc herniation and Mobic I changes on MRI. Half of the group received 100 days of antibiotics (Bioclavid similar to amoxicillin-clavulanate/Augmentin) and half received a placebo. At 100 days and 1 year after enrollment, those who received antibiotics had less disability, less back pain, fewer days off work, and less leg pain compared to the placebo group.
Experts commented that this study is a paradigm shift in the way we view and treat chronic low back pain. Study authors noted that getting patients to take 100 days of antibiotics may be problematic. They noted that further study needs to be done to identify who will truly benefit from this therapy.