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Ear to the Ground

Antibiotics Could Cure 40 Percent of Chronic Back Pain Patients

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Posted on May 9, 2013
SOMBILON ART, MEDIA and PHOTOGRAPHY (CC BY-ND 2.0)

Danish scientists have discovered that many cases of chronic back pain are caused by bacterial infections, which means they could be cured cheaply with antibiotics rather than surgery.

Peter Hamlyn, a surgeon at University College London hospital whom The Guardian describes as “[o]ne of the UK’s most eminent spinal surgeons,” said the discovery is the most significant he has witnessed in his career and deserving of a Nobel Prize. “This is vast. We are talking about probably half of all spinal surgery for back pain being replaced by taking antibiotics,” he said.

Specialists have long known that infections are sometimes to blame for chronic back pain, but such cases were thought to be exceptional.

Experts caution that the breakthrough will not help sufferers of normal, acute or sub-acute back pain. But for people with chronic pain, the discovery could radically improve their lives. “These are people who live a life on the edge because they are so handicapped with pain,” said Dr. Hanne Albert of the Danish research team. “We are returning them to a form of normality they would never have expected.”

—Posted by Alexander Reed Kelly.

Ian Sample at The Guardian:

The Danish team describe their work in two papers published in the European Spine Journal. In the first report, they explain how bacterial infections inside slipped discs can cause painful inflammation and tiny fractures in the surrounding vertebrae.

Working with doctors in Birmingham, the Danish team examined tissue removed from patients for signs of infection. Nearly half tested positive, and of these, more than 80% carried bugs called Propionibacterium acnes.

The microbes are better known for causing acne. They lurk around hair roots and in the crevices in our teeth, but can get into the bloodstream during tooth brushing. Normally they cause no harm, but the situation may change when a person suffers a slipped disc. To heal the damage, the body grows small blood vessels into the disc. Rather than helping, though, they ferry bacteria inside, where they grow and cause serious inflammation and damage to neighbouring vertebrae that shows up on an MRI scan.

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