Antibiotics against chronic back pain?

Pain after a herniated disc can truly be "hell": If the gelatinous mass steps out of the outer fibrous ring and advances into the spinal canal, nerves of the spinal cord become sensitively irritated. Danish researchers now suspect for the first time that bacterial inflammation in the intervertebral discs could also be responsible for the pain.

Albert HB et al.: Does nuclear tissue infected with bacteria following disc herniations lead to Modic changes in the adjacent vertebrae? Eur Spine Y. 2013 Apr;22(4):690-6. 2013 Feb 10.

Bacteria as a trigger for chronic back pain? To investigate this hypothesis, scientists at the University of Aarhus examined 61 patients who underwent surgery due to a severe slipped disc. The tissue removed during the operation was examined for bacteria - with success: About half of the patients showed germs of an acne bacterium. In addition, those whose intervertebral disc was colonised with bacteria were found about five times more frequently with edema in the bone adjacent to the affected intervertebral disc (80%) than in the study participants without bacterial colonisation.

Gradual inflammatory process in the "sick" intervertebral disc

In another study, the team investigated the effect of antibiotic therapy on 162 patients with bone marrow edema who suffered from back pain for at least six months after a slipped disc. The result was clear: while patients receiving broad-spectrum antibiotics showed significant improvement after 100 days of treatment, patients taking placebo instead showed no reduction in pain. The Danish scientists assume that bacteria settle in the degeneratively altered tissue at the time of the slipped disc and initiate a creeping inflammatory process. According to the physician, antibiotic therapy would therefore be the first choice for many patients.

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