Antibiotics May Relieve Low Back Pain for Some Patients

Study draws skepticism and needs further research.

Arthritis Today—May 24, 2013

Antibiotic treatment may bring relief to certain patients who have chronic low back pain, according to a Danish study published recently in the European Spine Journal. But that claim has some back specialists skeptical.

Low back pain is so common in the United States that the National Institutes of Health (NIH) says nearly everyone will experience it at some point in their lives. There are many potential causes for lower back pain, but a main one is aging.

Arthritis – both osteoarthritis as well as inflammatory types such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis – can affect the bones in the spine, pelvis and sacrum, leading to stiffness, swelling and pain. Back pain can also be caused by a damaged muscle, a pinched nerve or spinal stenosis, in which the spinal canal narrows and compresses the spinal cord. Lower back pain is called chronic when the pain lasts more than three months.

In a second, small study published in the same journal, the Danish researchers argue that in some cases – when a patient has had a herniated disc in the lower back – that patient’s chronic low back pain is caused by a bacterial infection in nearby vertebrae. Standard treatment for bacterial infections of any kind is antibiotics.

Paul M. Cooke, MD, a physiatrist at Hospital for Special Surgery in New York City, who specializes in non-surgical approaches to back pain, says the chances the antibiotic helped by treating a bacterial infection in the spine is “a low probability” and feels the results of this study are “far from convincing.”

“We have these same patients [as those in the study] and we treat them without antibiotics successfully. If a bacterial infection was the problem, we would be having no success,” Dr. Cooke says.

Current treatments for chronic back pain include anti-inflammatory and pain medication, physical therapy and exercise, lifestyle changes (which could include weight loss or quitting smoking), and steroid injections if there has not been improvement.

The next step is more research.

Read the full story at arthritistoday.com.