New Melbourne trial on using antibiotics for back pain
Naturally, the antibiotic treatment will can only work when bacteria are at the root cause of chronic pain. The hypothesis that underlies the trial supposes “back pain may be caused by an infection in the spine. It is thought that after an injury to a spinal disc bacteria circulating in the bloodstream enter the disc and establish an infection which prevents healing and leads to ongoing pain.” Claus Manniche, a rheumatologist at the Spine Centre of Southern Denmark where the original trial was conducted said, “low-grade disc infection probably explains a minority of chronic back pain.”
To put the theory to the test, 162 Danish volunteers signed up. Each person had experienced pain in the lower back for at least six months and rated their levels of pain as moderate to severe. At the end of the trial their pain was diminished. When the participants returned 12 months later for more MRI examinations the pain had not returned. It appears that the antibiotics helped to reverse painful bone swelling, that is, the vertebrae and the end plate of a neighbouring disc shrunk to more normal proportions.
Although we are used to taking antibiotics to cure illnesses, the course of amoxicillin-clavulanate for the trial goes for 100 days, rather than usual week or two. As the course is so intensive, people on the Danish trial did experience side effects which you should be made aware of: nausea, vomiting, diarrhoea or even colitis (inflammation of the colon lining). Antibiotics are very effective at killing bacteria, however our gastrointestinal tract relies on gut flora for breaking down food. The realisation of how important gut flora is to humans is a recent discovery gaining more attention in the media and by scientists in the past few years.
Back pain is the leading cause of disability across the world. When it doesn’t alleviate after three months the condition is considered chronic and has massive impact across the sufferer’s employment, relationships and lifestyle. As 60% of Australians are expected to experience back pain during their lifetime finding a cure that is effective and safe is a high priority to help us all live longer and stronger. The antibiotics trial represents a complete change in our understanding of what causes back pain. It points to a bright future where effective and surgery free treatments that increase quality of life may help up to two thirds of the global population.
Further reading:
http://monash.edu/news/show/are-antibiotics-effective-for-low-back-pain
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3631045/
