For the millions of people who suffer from chronic back pain, relief may soon come in the form of antibiotics, bringing an end to the suffering and offering a simpler, cheaper option than surgery.
Researchers from the University of Southern Denmark and the University of Birmingham, England, report in the European Spine Journalthat as many as 40% of patients with a specific type of back pain associated with a slipped disc may be helped by the antibiotic amoxicillin clavulanate (Bioclavid).
Scientists discovered that the back pain in question is caused by a bacterial infection associated with acne. Although primarily found on the skin, the bacteria (Propionibacterium acnes) is also found in the mouth where it can be pushed into the circulation by tooth brushing.
“The antibiotic protocol in this study was significantly more effective for this group of patients than placebo in all the primary and secondary outcomes,” researchers wrote. “For the primary outcome measures, disease-specific disability and lumbar pain, the effect magnitude was also clinically significant.”
It is believed that although the slipped disc gradually had healed itself, patients remained in pain due to the Propionibacterium acnes bacteria.
The Mayo Clinic estimates that 80% of all Americans will have lower back pain at least once in their lives, with a large portion developing chronic back pain. Back pain is reportedly the most common reason for absence from work in the U.S.
Dr. Hanne Albert, the Danish scientist who made the discovery, told the Daily Mail that almost half of those with chronic lower back pain could benefit from antibiotics.
“These are moms and dads in the middle of an active working life,” said Dr. Albert. “These are pillars of society; they care for their parents and for their children.”
“They will be able to play with their children, instead of just sitting and watching them play.”
Most experts previously suspected that bacterial infection only played a minor role in back pain.
But in the first of two studies on the subject, Albert and her team demonstrated how bacteria invades the site of a slipped disc, causing painful inflammation and damaging surrounding vertebrae.
In the second study, researchers recruited 162 adult patients who had lower back pain for more than six months following a spinal disc herniation (slipped disc).
They also had to have disease-related changes in the vertebrae next to the slipped disc site. The bone edema (swelling) was then confirmed through multiple MRI scans.
In a double blind randomized control trial, patients were given either an antibiotic or a placebo for 100 days. Doctors say patients who received antibiotics reported they were effective in 80% of the cases.
One year after the treatment began, patients reported the intensity of their back pain was cut in half.
“I can’t tell you how many people have given me hugs and told me I have given them their life back,” said Dr. Albert.
Patients who had taken the antibiotic reported they experienced an average of 64 hours of pain in the previous month compared to those on placebo who racked up 200 hours of pain. The antibiotic group also reported taking just 19 sick days compared to 45 days by those on placebo.
Before patients begin a regimen of antibiotics, the study’s authors say they should first consult with their physician. They warn against the indiscriminate and excessive use of antibiotics, as bacteria can become resistant to antibiotics over time.
They also add that although the findings of their research are positive, it will need to be confirmed in bigger studies in more diverse populations.
One doctor not involved in the study, believes it will force his colleagues to rethink their understanding of lower back pain.
“More work needs to be done but make no mistake, this is a turning point, a point where we will have to re-write the textbooks,” said Dr. Peter Hamlyn, a neurosurgeon from University College London hospital.
“It is the stuff of Nobel prizes.”