May 7, 2013

expert reaction to use of antibiotics to cure chronic back pain

In two papers published in the European Spine Journal, a Danish team working with doctors in Birmingham found that 20-40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery.

Dr Donal McNally, Associate Professor and Reader in Bioengineering, University of Nottingham, said:

“This is an extremely important piece of research which shows that a large proportion of people develop a very low level of infection in their intervertebral discs following a disc herniation and that a standard antibiotic treatment is effective in relieving pain and disability in patients who might have this type of infection (with a one year follow-up).  More than 3,000 people in England attended outpatient clinics with displaced discs in their necks or lower backs in 2011-12, this research demonstrates that about 1,200 of these people may have been helped by the antibiotic treatment to control subsequent low back pain.  However, as the authors note, this is a specific treatment for a specific form of low back pain (following disc herniation), and it should be seen in the context of the 16,500 people who attended outpatient clinics with low back pain over the same time period.”

Prof Laura Piddock, Professor of Microbiology and Deputy Director of The Institute of Microbiology and Infection, University of Birmingham, & Director, Antibiotic Action, said:

“Consistent with the Department of Health’s ‘Start Smart, Then Focus’ campaign, antibiotics should only be used to treat back pain once a bacterial cause has been identified. Otherwise many patients could be exposed to antibiotics needlessly, and antibiotic resistant bacteria that live on their skin and in their gut could be selected. For this reason, physicians are encouraged to liaise with their Consultant Microbiologist colleagues for the most appropriate tests to carry out.”