By Laura Donnelly
UP to four in 10 cases of chronic lower back pain could be cured by antibiotics, new Danish research has suggested – and these radical findings follow years of debate about the cause of such discomfort and the best way to treat it.
One leading neurosurgeon said the finding was a "turning point" so important that the researchers behind it deserved a Nobel prize.
Experts likened the findings to the breakthrough 30 years ago, when the bacteria Helicobacter pylori was found to be the cause of stomach ulcers, radically changing the way they were treated.
But infection experts cautioned against widespread long-term prescribing of antibiotics, which could increase drug resistance across the population, triggering a rise in superbugs.
About five million people in Britain will suffer chronic back pain at some point in their lives, and the cause is often not clear.
GPs normally recommend exercises and anti-inflammatory drugs, with spinal surgery in the most severe cases. Millions of people also turn to physiotherapy, chiropracty and osteopathy in an attempt to manage their symptoms.
The research by the University of Southern Denmark found that almost half of cases of chronic lower back pain could in fact be caused by bacteria. Of those, most were cured or significantly improved by one three-month dose of antibiotics – at a cost of just £114 (R1766) per patient – the study found.
Currently, the National Health Service spends more than £1-billion (R15.5-billion) a year on treatment of back pain, while patients spend at least £600-million (R9296-million) a year on private healthcare and alternative remedies.
The Danish studies, published in the European Spinal Journal, found the presence of bacteria in 46% of patients suffering from chronic lower back pain following a slipped or herniated disc.
Researchers suggested that the problems occur because, when a disc becomes herniated, bacteria can enter and cause an infection – causing bone swelling and persistent pain.
Their second study of 162 patients found that when such cases were given the antibiotic combination Amoxicillin and clavulanate, 80% were cured or saw a significant reduction in pain levels.
Peter Hamlyn, a consultant neurologist and spinal surgeon at University College London Hospital said the discoveries were so significant that in future, half of all patients who would otherwise endure spinal surgery might instead be helped by antibiotics.
While more research was required to confirm the findings, he said the discovery appeared to be a major breakthrough in tackling one of the most common causes of disability.
He said: "Make no mistake this is a turning point, a point where we will have to re-write the textbooks," he said. "It is the stuff of Nobel prizes." – The Telegraph