May 13, 2013

Antibiotics could cure 40% of chronic back pain patients

Up to 40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery. Surgeons in the UK and elsewhere are reviewing how they treat patients with chronic back pain after scientists discovered that many of the worst cases were due to bacterial infections. Many patients with unrelenting lower back pain will no longer face major operations but can instead be cured with courses of antibiotics costing around £114 (US$170).

One of the UK's most eminent spinal surgeons said the discovery was the greatest he had witnessed in his professional life, and that its impact on medicine was worthy of a Nobel prize.

"This is vast. We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics," said Peter Hamlyn, a consultant neurological and spinal surgeon at University College London hospital.

The Danish team describe their work in two papers published in the European Spine Journal.

In the first report, they explain how bacterial infections inside slipped discs can cause painful inflammation and tiny fractures in the surrounding vertebrae. The Danish team examined tissue removed from patients for signs of infection. Nearly half tested positive, and of these, more than 80% carried bugs called Propionibacterium acnes. The microbes are better known for causing acne. They lurk around hair roots and in the crevices in our teeth, but can get into the bloodstream during tooth brushing. Normally they cause no harm, but the situation may change when a person suffers a slipped disc. To heal the damage, the body grows small blood vessels into the disc. Rather than helping, though, they ferry bacteria inside, where they grow and cause serious inflammation and damage to neighbouring vertebrae that shows up on an MRI scan.

Read more at NBF