Antibiotics could cure 40% of chronic back pain patients Scientists hail medical breakthrough by which half a million UK sufferers could avoid major surgery and take antibiotics instead
Up to 40% of patients with chronic back pain could be cured with a course of antibiotics rather than surgery, in a medical breakthrough that one spinal surgeon says is worthy of a Nobel prize.
Surgeons in the UK and elsewhere are reviewing how they treat patients with chronic back pain after scientists discovered that many of the worst cases were due to bacterial infections.
The shock finding means that scores of patients with unrelenting lower back pain will no longer face major operations but can instead be cured with courses of antibiotics costing around �114.
One of the UK's most eminent spinal surgeons said the discovery was the greatest he had witnessed in his professional life, and that its impact on medicine was worthy 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," said Peter Hamlyn, a consultant neurological and spinal surgeon at University College London hospital.
Hamlyn recently operated on rugby player Tom Croft, who was called up for the British and Irish Lions summer tour last month after missing most of the season with a broken neck.
Specialists who deal with back pain have long known that infections are sometimes to blame, but these cases were thought to be exceptional. That thinking has been overturned by scientists at the University of Southern Denmark who found that 20% to 40% of chronic lower back pain was caused by bacterial infections.
In Britain today, around 4 million people can expect to suffer from chronic lower back pain at some point in their lives. The latest work suggests that more than half a million of them would benefit from antibiotics.
"This will not help people with normal back pain, those with acute, or sub-acute pain � only those with chronic lower back pain," Dr Hanne Albert, of the Danish research team, told the Guardian. "These are people who live a life on the edge because they are so handicapped with pain. We are returning them to a form of normality they would never have expected."
Claus Manniche, a senior researcher in the group, said the discovery was the culmination of 10 years of hard work. "It's been tough. There have been ups and downs. This is one those questions that a lot of our colleagues did not understand at the beginning. To find bacteria really confronts all we have thought up to this date as back pain researchers," he said.
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.
In the second paper, the scientists proved they could cure chronic back pain with a 100-day course of antibiotics. In a randomised trial, the drugs reduced pain in 80% of patients who had suffered for more than six months and had signs of damaged vertebra under MRI scans.
Albert stressed that antibiotics would not work for all back pain. Over-use of the drugs could lead to more antibiotic-resistant bacteria, which are already a major problem in hospitals. But she also warned that many patients will be having ineffective surgery instead of antibiotics that could alleviate their pain.
"We have to spread the word to the public, and to educate the clinicians, so the right people get the right treatment, and in five years' time are not having unnecessary surgery," she said.
Hamlyn said future research should aim to increase the number of patients that respond to antibiotics, and speed up the time it takes them to feel an improvement, perhaps by using more targeted drugs.
The NHS spends �480m on spinal surgery each year, the majority of which is for back pain. A minor operation can fix a slipped disc, which happens when one of the soft cushions of tissue between the bones in the spine pops out and presses on nearby nerves. The surgeons simply cut off the protruding part of the disc. But patients who suffer pain all day and night can be offered major operations to fuse damaged vertebrae or have artificial discs implanted.
"It may be that we can save �250m from the NHS budget by doing away with unnecessary operations. The price of the antibiotic treatment is only �114. It is spectacularly different to surgery. I genuinely believe they deserve a Nobel prize," said Hamlyn. Other spinal surgeons have met Albert and are reviewing the procedures they offer for patients.
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-------------------- --Lymetutu-- Opinions, not medical advice! Posts: 96222 | From Texas | Registered: Feb 2001
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sparkle7
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I think people assume aches & pains can be caused by Lyme &/or co-infections but it can be other things, too.
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desertwind
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Consider the anti-inflam. effects of some abx.s. My aches and pains always feel better on certain abx.s - I believe in part due to the anti-inflam. factor.
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GiGi
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All disease is caused by high toxicity levels and the invasion of multiple pathogens. It's been in the news for decades. Antibiotics are not the answer.
Look up the greek or latin meaning of antibiotics.
The backache may be gone, but fungi takes over and eventually kills all in the end.
We have to change our ways. Fluoride in our drinking water and breathing/eating/drinking nanonized aluminum oxide from geoenrineered chemtrailing is not going to do it.
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sparkle7
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I understand. It's just that it's a radically different concept (as opposed to doing surgery) to think of pain being caused by pathogens. Not so radical for those in the know - but massive for the general populace.
How much money do you think doctors will lose by not doing surgeries for back pain? I know several people who have had or have been told to have surgeries for back pain & they still have pain.
Bottom line - the onslaught of chemicals, EMFs & pathogens are probably the cause of most of our illness. It's just that this is a shift in thinking.
I don't know if this will even make it to the average media coverage. I'm sure they are making alot of money off of unnecessary surgeries.
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ukcarry
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A useful piece of info from the article is that MRI scans can spot suitable candidates for antibiotics. At least an MRI might tell you whether your pain is caused by bacteria and then it is up to you whether or not you use abx to treat.
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sparkle7
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desertwind - It's probably the pathogens which cause the inflammation... It's best to get rid of the pathogens by allopathic or natropathic means. Tumeric is also good for inflammation. I have been taking a product with boswelia & tumeric on & off.
I'd like to treat the root cause, though. I decided to try the MMS in a very dilute form. I think it's called the Protocol 1000. Anti-parasite treatment helps me, too.
I bet alot of aches & pains also come from parasites.
ukcarry - I'd have to look into what is effective against Propionibacterium acnes - maybe there's an herb or some natural solution...?
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ukcarry
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There may be other bacterial causes, ie one of the common Lyme infections themselves.
I notice with my severe lower back and coccyx problem that the intensity of the pain is incredible variable: always uncomfortable, needing multiple approaches to enable me to sit, but sometimes excruciating for a period.
This makes me think that infection may be causative and it prompted me to start Cowden, as I had previously had a spell of mainly support and detox. I also think my totally blown disc must be Lyme related. The top London Chiro I saw seemed surprised that I had not had a major sporting injury or accident.
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TX Lyme Mom
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It's often helpful to have a copy of the abstract from PubMed to show to your doctor if you are interested in seeing this form of therapy because doctors pay more attention to the original medical reference than they do to articles in the popular press. Here are links to PubMed abstracts by these same authors about their antibiotic treatment:
posted
the bacterium is Propionibacterium acnes and there are several interesting results when googling it. The medicine is Augmentin / Bioclavid (it is generic so there are lots of brand names) which is Amocillin and Clavulanic Acid potassium combined.
The article in the uk papers are a result of an announcement from a clinic called MAST http://www.mastmedical.com check the link News
The interesting part is that one needs to take these antibiotics for a long time since there is no blood supply to discs and antibiotics need a long time to reach the discs and bacteriae.
Haven�t we heard that before? (antibiotics do not reach connective tissues) Borrelia likes to hide out in connective tissue where antibiotics do not reach.
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sparkle7
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Thanks for the info! You guys are great researchers. It's so good to have people thinking from all of these angles & approaches.
It's very possible that many pathogens could be causing this effect. Not just the acne pathogen. Could be viral or parasite, too. Herpes also lives in the nerves in the spine - if I'm not mistaken.
I'm just glad to see that the medical establishment is thinking in this manner. It's pretty strong wording to say that this research should be awarded a Nobel prize... even if it was just in the Guardian.
How long will it take for the mainstream to hear about this, I wonder? They make so much money off of surgeries - I wouldn't be surprised if they never publicize it.
It's a shame there's a profit motive in healing people. Capitalism may be a good model for some things but not when it comes to dealing with people's human rights.
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