Low Back Pain Linked to Bacterial Infection
It is possible that 40% of chronic low back pain is related to bacterial infection. A study published in European Spine Journal revealed that a group of patients with both disc herniation and Modic type 1 changes demonstrated by MRI could be helped by antibiotic therapy.
Modic changes are associated with bone edema or swelling. This swelling can be associated with infection. When patients with Modic changes had back surgery, tissue samples revealed bacterial infection in 46% of the cases. The primary author, Hanne B. Albert, PhD, states that Propionibacterium was most commonly identified. These bacteria are normally found in human skin, hair and gums.
The researchers then treated 162 adults who suffered with chronic low back pain for 6 or more months and had Modic changes on MRI with an antibiotic course. The treatment group of the study showed statistically significant improvement of let pain, number of hours with pain, global perceived health and missed days of work.
This study suggests that low-grade infection should be considered as a cause of pain in patients with disc herniations and Modic type 1 changes. Hopefully, future studies more clearly identify which patients would benefit from antibiotic therapy.