Intended for healthcare professionals


Study proposes antibiotics as possible new treatment for some types of chronic low back pain

BMJ 2013; 346 doi: (Published 09 May 2013) Cite this as: BMJ 2013;346:f2988
  1. Jacqui Wise
  1. 1London

Up to 40% of patients with chronic low back pain that could benefit from surgery have a bacterial infection that could be treated simply and cheaply with antibiotics, research has found.

The first of two studies in the European Spine Journal found Propionibacterium acnes, an anaerobic bacteria, in 43% of patients undergoing primary surgery for lumbar disc herniation.1 Hanne Albert and colleagues at the University of Southern Denmark also found that new bone oedema (Modic type 1 changes) developed in adjacent vertebrae of 80% of discs infected with the anaerobic bacteria.

Previous studies had shown that Modic changes were six times as common in people with low back pain as in the general population. This was mostly thought to be the result of mechanical reasons, but it was known that under some circumstances infections played a role. Conventional treatments for back pain such as exercises, injections, and manipulation were ineffective in patients with Modic changes.

The study of 61 patients found a highly significant association between …

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